Objective To explore the curative effect of prealbumin (PA) in the hand-foot-and-mouth dis-ease and analysis its value in monitoring and prognosing this disease. Method Detect levels of serum PA of 390 ca-ses of children before, after and during the treatment and compare the changes during the treatment. Then observe the prognosis. Results There are significant difference of PV levels between cases of different prognosis (P < 0.05). Conclusion The PV levels of children of hand-foot-and-mouth disease will change significantly after effective treat- ment. There are clinical significance in observing and prognosing the hand-foot-and-mouth disease by detecting the se-rum PV levels.

Objective To discuss the operative strategies for cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis.Methods Retrospectively analyzed 21 cases of cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic kyphosis,who underwent surgeries from January,2007 to August,2014.Twenty males and 1 female were included.Mean age was (48.6±7.5) years (range,36-65 years).The preoperative American Spine Injury Association (ASIA) classification distribution:2 cases of Grade A,6 cases of Grade B,7 cases of Grade C,5 cases of Grade D,and 1 case of of Grade E.The investigative surgical methods including posterior cervical open reduction,internal fixation and bone graft fusion;posterior cervical open reduction/decompression,internal fixation and bone graft fusion;or combined posterior and anterior cervical decompression,bone graft fusion and instrumentation.The operative time and blood loss were recorded,the clinical therapeutic effect was evaluated by visual analogue scale (VAS) score,ASIA grade improvement,cervical curvature (the angle between a line drawn parallel to the inferior endplate of C2 and a line drawn parallel to the inferior endplate of C7 in the lateral plane of an X-ray image) and radiological assessment (including bone graft fusion condition and internal fixation position).Results One case died from severe pulmonary infection and respiratory failure at the 45th day after operation.All the other 20 patients obtained complete follow-up with a mean time of (39.4±8.76) months (range,25-59 months).7 cases received posterior cervical open reduction,internal fixation and bone graft fusion,average operative time was (92.1±5.4) minutes and average blood loss was (96.1+23.7) ml.9 cases received the posterior cervical open reduction and decompression,internal fixation and bone graft fusion,mean operation time was (121.4± 14.0) minutes and blood loss was (250.0±38.9) ml.3 cases experienced combined posterior and anterior cervical decompression,bone graft fusion and fixation,average operative time was (222.4± 14.9) minutes and average blood loss was (354.3+46.7) ml.Mean of VAS scores at the 3th month postoperatively was 2.76±0.46,significantly lower than the preoperatively VAS scores (8.95±0.36).Mean of VAS scores at the 24th month postoperatively was 1.77±0.39,significantly lower than those at the 3th month postoperatively.The neurological function of spinal cord achieved significant improvement after operations and continued recovered gradually in the subsequent follow up.ASIA Classification distribution at the 24th month postoperatively was:0 case of Grade A,0 case of Grade B,3 cases of Grade C,8 cases of Grade D,9 case of Grade E.Mean of the cervical curvature after operation was-7.1°± 1.9°,significantly higher than preoperatively(-13.4°±3.3°) and did not have any loss of Cobb's angles at 24th month after operation.All the surviving cases achieved solid bone graft fusion.Mean bone graft fusion time was 5.8 months (range,4-9 months).There was no internal fixation loose,fracture and dislocation occurred during follow up.Conclusion All procedures can significantly relieve the painful symptoms,effectively restore the normal cervical alignment and stability,and remarkably improve the neural function of the patients suffering cervical spine fracture combined with ankylosing spondylitis and the deformity of cervicothoracic junction kyphosis.

OBJECTIVETo study different effects of Herba Lycopodii (HL) Alcohol Extracted Granule combined methylprednisolone on behavioral changes, brain derived neurotrophic factor (BDNF) expression levels, and N-methyl-D-aspartate (NMDA) receptor levels in rats with spinal cord injury (SCI).

METHODSMale adult SD rats were randomly divided into five groups, i.e., the sham-operation group, the model group, the HL treatment group, the methylprednisolone treatment group, the HL + methylprednisolone treatment group. Rats in the HL treatment group were intragastrically administered with HL at the daily dose of 50 mg/kg for 5 successive days. Rats in the methylprednisolone treatment group were intramuscularly injected with 50 mg/kg methylprednisolone within 8 h after spinal cord contusion, and then the dose of methylprednisolone was reduced for 10 mg/kg for 5 successive days. Rats in the HL + methylprednisolone treatment group received the two methods used for the aforesaid two groups. Basso Beattie and Bresnahan (BBB) score (for hindlimb motor functions) were assessed at day 0, 3, 7, and 28 after operation. At day 13 after SCI, injured spinal T8-10 was taken from 8 rats of each group and stored in liquid nitrogen. The N-methyl-D-aspartate (NMDA) receptor affinity (Kd) and the maximal binding capacity (Bmax) were determined using [3H]MK-801 radioactive ligand assay. Rats' injured spinal cords were taken for immunohistochemical assay at day 28 after SCI. Expression levels of BDNF in the ventral and dorsal horn of the spinal cord were observed.

RESULTSCompared with the sham-operation group, the number of BDNF positive neurons in the ventral and dorsal horn of the spinal cord increased in the model group, Bmax increased (470 ± 34), Kd decreased, and BBB scores decreased at day 3 -28 (all P <0. 05). Compared with the SCI model group, the number of BDNF positive neurons and Kd increased, BBB scores at day 3 -28 increased (P <0. 05) in each medicated group. Bmax was (660 ± 15) in the methylprednisolone treatment group, (646 ± 25) in the HL treatment group, and (510 ± 21) in the HL +methylprednisolone treatment group (P <0. 05). Compared with the methylprednisolone treatment group, the number of BDNF positive neurons and Kd increased, BBB scores at day 7 -28 increased, and Bmax decreased in the HL treatment group and the HL + methylprednisolone treatment group (all P <0. 05). Compard with the HL treatment group, the number of BDNF positive neurons and Kd increased, and Bmax decreased (all P < 0.05).

CONCLUSIONSHL could effectively improve motor functions of handlimbs, increase expression levels of BDNF in the spinal cord, and lessen secondary injury by affecting spinal levels of NMDA receptors. It showed certain therapeutic and protective roles in treating SCI. Its effect was better than that of methylprednisolone with synergism.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ethanol ; Male ; Methylprednisolone ; pharmacology ; therapeutic use ; Models, Animal ; N-Methylaspartate ; metabolism ; Neurons ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; Spinal Cord Injuries ; drug therapy ; metabolism

Objective:To explore the potential role of amyloid precursor protein (APP) in the sodium-channel-voltage-beta 2B (SCN2B)-mediated improvement of memory and cognitive function in Alzheimer's Disease (AD).Methods:The SCN2B gene knockout mice (SCN2B -/-) were hybridized with APP gene knockout mice (APP -/-), APP gene heterozygous mice (APP +/-) and APP gene transgenic mice (APP +/+), and the tail tissue of the same mouse was genotyped by PCR gene detection.The mice were divided into SCN2B -/-APP -/- group, SCN2B -/-APP +/- group and SCN2B -/-APP +/+ group.The C57BL/6 wild-type mice were Wild type (WT) group, with 9 mice in each group.SCN2B -/-APP -/-, SCN2B -/-APP +/-, SCN2B -/-APP +/+ transgenic mice and the wild-type mice at the age of 6 months, 12 months, and 18 months were tested by Morris water Maze and Y maze test to detect the cognitive function between each group.Meanwhile, SCN2B -/-APP -/-, SCN2B -/-APP +/-, SCN2B -/-APP +/+ transgenic mice aged 6, 12, 18 months and age-match wild-type were selected to detect neuronal processes in hippocampal CA1 region, and the number of neuronal processes in basal and distal regions of hippocampal CA1 region was quantitatively analyzed.SPSS 21.0 statistical software was used for data statistics and analysis.The differences between the two groups were compared and analyzed by independent-sample t test, the comparison between multiple groups was analyzed by one way analysis of variance (ANOVA), and repeated measurement ANOVA was used to analyze behavioral deta. Results:Repeated measurement ANOVA was used to analyze the data of water maze test. The data showed that the interaction effect of escape latency group and time was significant in 18 month old mice ( Ftime×group=3.63, P<0.01). Simple effect analysis showed that compared with SCN2B -/-APP +/- group and SCN2B -/-APP -/-group, the escape latency of mice in SCN2B -/-APP +/+ group was significantly prolonged from day 4 to 6 (4th day: (47.00±2.00)s, (43.11±1.96) s, (41.89±3.06)s, t=-4.16, 1.00, both P<0.05; 5th day: (45.22±2.54) s, (36.33±2.78) s, (37.00±2.45)s, t=-7.08, -0.54, both P<0.05; 6th day: (38.11±2.03)s, (34.11±2.32)s, (33.00±2.91)s, t=-3.90, 0.90, both P<0.05). The residence time in the target quadrant was shortened((18.00±1.73)s, (25.56±1.33)s, (24.33 ±1.94)s; t=10.37, 1.56, both P<0.05). (2) Y-maze results showed that compared with SCN2B -/-APP +/- group and SCN2B -/-APP -/-group, the number of novel arm entry in 18 month old mice in SCN2B -/-APP +/+ group was decreased((50.22±3.68), (57.22±3.74), (58. 44±5.14) ; t=3.40, -0.48, both P<0.05), and the residence time of stay in the new arm was reduced((10.89±0.62)min, (14.33±0.59)min, (13.89±0.74)min; t= 8.16, 0.44, both P<0.05), and the distance of movement in the new arm was significantly reduced ((37.26±2.01)m , (45.67±2.45)m , (46.11±3.27)m ; t=7.81, 0.91, both P<0.05). (3) Golgi staining showed that SCN2B -/-APP +/- group and SCN2B -/-APP -/-group, the number of apical dendrites in hippocampal neurons of 18 month old mice in SCN2b -/-App +/+ group(number of apical dendrites: (1.78±0.37), (3.67±0.81), (3.00±1.21); t=3.36, 1.41, both P<0.05) and the number of basal dendrites (the number of basal dendrites: (1.11±0.50), (3.11±0.50), (2.56±0.69); t=4.06, 1.21, both P<0.05). Conclusion:SCN2B knockdown can improve the ability of spatial learning and memory in aged mice.Overexpression of APP can partially offset the improvement of cognitive function caused by SCN2B knockdown, and may be affected by the number of basal and distal processes of neurons in the hippocampal CA1 region of the mice.

Objective:To explore the postoperative biliary leakage and severe complication rate and its related risk factors of hepaticojejunostomy (HJ) for biliary disease.Methods:The clinical data of patients undergoing HJ for benign biliary diseases at the First Affiliated Hospital of Anhui Medical University from Jan 2003 to Dec 2017 were retrospectively analyzed. Multi-factor analysis was used to find a risk factor for postoperative bile leakage and severe complications.Results:Two hundred and eighty-three patients received HJ. The median age was 39 years.The short-term complication rate after surgery was 19.1% ( n=54), and the biliary leakage rate was 11.7% ( n=33), and the severe complication rate was 15.2% ( n=43). By multi-factor analysis: preoperative sepsis[ OR=3.875, 95% CI (1.583, 9.485), P=0.003], liver cirrhosis [ OR=3.212, 95% CI (1.001, 10.307), P=0.050], intraoperative blood loss≥400 ml [ OR=6.054, 95% CI (1.231, 29.781), P=0.027],postoperative hospitalization ≥9 days [ OR=6.738, 95% CI (2.287, 19.855), P=0.001] are the independent risk factors for postoperative bile leakage. Main bile duct stone[ OR=2.764, 95% CI (1.174, 6.510), P=0.020], preoperative sepsis [ OR=4.310, 95% CI (1.666, 11.149), P=0.003], intraoperative bleeding ≥400 ml [ OR=5.944, 95% CI (1.231, 29.781), P=0.022] and postoperative hospitalization ≥ 9 days [ OR=11.422, 95% CI (1.317, 49.859), P=0.001] are the independent risk factors for serious complications. Conclusions:HJ should be conducted when the sepsis was under control and sufficient bile drainage.The patients' condition should be comprehensively and accurately assessed before operation. The indications for partial hepatectomy need to be strictly defined.

The 11α-hydroxylation of 16α, 17-epoxyprogesterone (EP) catalyzed by Rhizopus nigricans is crucial for the steroid industry. However, lower conversion rate of the biohydroxylation restricts its potential industrial application. The 11α-steroid hydroxylase CYP509C12 from R. oryzae were reported to play a crucial role in the 11α-hydroxylation in recombinant fission yeast. In the present study, the CYP509C12 of R. oryzae (RoCYP) was introduced into R. nigricans using the liposome-mediated mycelial transformation. Heterologous expression of RoCYP resulted in increased fungal growth and improved intracellular reactive oxygen species content in R. nigricans. The H₂O₂ levels in RoCYP transformants were approximately 2-folder that of the R. nigricans wild type (RnWT) strain, with the superoxide dismutase activities increased approximately 45% and catalase activities decreased approximately 68%. Furthermore, the 11α-hydroxylation rates of EP in RoCYP transformants (C4, C6 and C9) were 39.7%, 38.3% and 38.7%, which were 12.1%, 8.2% and 9.4% higher than the rate of the RnWT strain, respectively. This paper investigated the effect of heterologous expression of RoCYP in R. nigricans, providing an effective genetic method to construct the engineered strains for steroid industry.

Objective Focusing on the evaluation system of senior health professional titles in Shanghai,it discusses the rationality of the existing policies from the perspective of clinicians who plan to participate in the promotion,and put forward suggestions for optimizing the content and form of the evaluation.Methods Online questionnaire surveys had been conducted for all clinicians who participated in the application for Shanghai's senior health professional titles in 2020 to collect the personal information and their attitudes towards the professional title review system.R 4.0.2 soft-ware was used to conduct statistical description,cluster analysis,chi-square test,non-parametric test,etc.Results A to-tal of 1,674 people from 32 clinical specialties were surveyed.According to the two factors of growth space and growth speed,the participating subjects are divided into four different categories of groups,which are named according to the sample characteristics:Stars,Mainstay and Veteran.There are no differences among the three groups in the familiarity,and difficulty evaluation of clinical indicators for the senior health professional title evaluation system.The proportion of Veteran considered unreasonable is relatively high.There are differences among the three groups in overall difficulty level,scientific research difficulty and qualification difficulty.Conclusion The incentive attribute of the health technical person-nel senior title evaluation system should be continuously strengthened,and the differentiated characteristics of the de-velopment of health talents should be paid attention to.Big data can be used to highlight the quantification and differen-tiation of clinical competency evaluation indicators,which can effectively improve the scientific level of professional title evaluation.

The assessment of physicians'clinical competence is pivotal for fostering their professional growth and enhancing the quality of healthcare services.Despite this,a universally recognized and standardized system for as-sessing physicians'clinical competence remains to be established in China.Drawing on international practices in clini-cal competence assessment,provided a summary of the commonly utilized tools and methods for evaluating physi-cians'clinical competence.It also proposed recommendations for the development of a clinical competence assess-ment system in China.In the current practice of assessing physicians'clinical competence in China.It advocated for the establishment of a unified framework for clinical competence assessment,encouraging graded and classified as-sessments and a patient-centered,quality-improvement-oriented system for evaluating clinical competence.The uti-lization of big data will bring new opportunities for the assessment of healthcare personnel and the overall quality of medical services in China.

Objective It combines medical big data and machine learning techniques to explore clinical outcomes based clinical physician performance evaluation method.Methods The non-negative principal component analysis(NPCA)was used in cases.Based on the non-negative sparse principal component analysis(NSPCA),a comprehen-sive index fitting was performed on 11 clinical performance indicators of 170 clinicians treating cardiovascular diseases.At the same time,confidence intervals were constructed based on root cause assessment techniques to calculate the range of indicators for each clinician.Results The coincidence rate of outpatient discharge diagnosis,the rate of grade A healing of surgical incision,the proportion of surgical patients,the rate of 3-day diagnosis,the proportion of third-grade and fourth-grade surgery,the completion of surgery and the number of operations were significant in dis-tinguishing the work performance of clinicians.However,the average length of hospital stays before surgery,the rate of unplanned readmission within 30 days,the average length of hospital stays of discharged patients,the main diag-nosis and cure/improvement,and the number of patients admitted were not significant in distinguishing the clinical work performance of clinicians.The overall work performance of all clinicians can be ranked through comprehensive index fitting,and the further evaluation of high,middle and low performance of each specific index can reveal the potential reconstruction dimensions of each clinician.Conclusion It utilizes machine learning techniques to achieve a comprehensive evaluation of clinical performance,utilizing medical big data as the foundation.It holds the potential to provide important support for a more scientific and objective assessment of clinical performance.

Norovirus, as one of the main pathogens causing non-bacterial gastroenteritis, can cause serious public health problems and economic losses around the world. In recent years, the outbreaks caused by the virus in China are on the rise. Human Norovirus (HuNoV) can hardly be cultivated in-vitro. The nucleic acid detection method (such as RT-qPCR) has the highest sensitivity and specificity, but it was not established that the correlation between the detected viral genome and viral infectivity, which leads to inaccurate judgment of safety risks. Here, the in-vitro and in-vivo culture models, viral genome integrity and capsid protein integrity were cut into three aspects. The research progress and characteristics of infectious Norovirus identification technology in recent years were reviewed and discussed, and the future development trend of this technology was prospected. The aim is to further improve the accuracy of Norovirus quantitative detection and provide a theoretical basis for its application in the field of food safety testing.