Objective To investigate physiological changes in peri extracorporeal circulation period of patients who underwent cardiac valve replacement surgeries with crystalloid solution mixed with colloidal solutions and pure crystal solution as extracorporeal circulation priming solution, and explore the clinical value and practicability of crystalloid solution as the sole extracorporeal circulation priming solution.Methods A retrospective analysis was performed in 130 patients who underwent cardiac valve replacement surgeries.Pure lactated Ringer's solution liquid and Lactated Ringer's solution mixed with Voluven as the extracorporeal circulation priming solution were used.We respectively compared hematocrit at different time points, postoperative blood routine, liver and kidney function, blood coagulation index, duration of intensive care and trachea cannula in two groups.Results There were no significant differences in ages, preoperative blood routine, kidney function, blood coagulation function, duration of operation, clamping time, bypass time, intensive care, postoperative blood routine, kidney function, blood coagulation function and hematocrit at different time points in two groups (P ＞0.05).However, the hospital day of group which used crystalloid solution as extracorporeal circulation priming solution was significant shorter compared to group which used lactated Ringer's solution mixed with Voluven (P ＜ 0.05).Alanine aminotransferase of group which used crystalloid solution as extracorporeal circulation priming solution was significant higher compared to group which used lactated Ringer's solution mixed with Voluven (P ＜0.01).Conclusions Crystalloid solution as extracorporeal circulation priming solution is safe and economy in cardiopulmonary bypass.Pure crystalloid solution as the sole extracorporeal circulation priming solution can be safely used on patients (New York Heart Association class Ⅱ-Ⅲ) who have normal liver and kidney function before the operation of adult heart valve replacement with cardiopulmonary bypass.

Objective: Safety and immunogenicity regarding simultaneous vaccination on both hepatitis E and hepatitis B vaccines were studied. Methods: A total of 600 healthy subjects aged 18-60 were recruited in Chaoyang district of Beijing city, from September 2015 to December 2016. Subjects meeting the inclusion and exclusion criteria were randomly divided into 3 groups: the simultaneous vaccination group of hepatitis E and hepatitis B, the hepatitis B vaccination group and the hepatitis E vaccination group. Members of the 3 groups were all inoculated according to the procedure of '0, 1 and 6 months’. Safety and immunogenicity of the simultaneous vaccination group was compared with the individual vaccination groups. Results: Vaccination groups had 601 subjects, involved with having 150 subjects of hepatitis E vaccination group, 159 subjects of hepatitis B vaccination group, and 292 subjects of simultaneous vaccination of hepatitis E and hepatitis B. Local adverse reactions that mostly common seen, would include pain (25.0%, 73/292), redness (12.7%, 37/292), pruritus (9.2%, 27/292), callus (8.9%, 26/292), swelling (8.2%, 24/292) at the inoculation sites. Systemic adverse reactions would include fever (7.2%, 21/292), headache (5.8%, 17/292), muscle pain (5.5%, 16/292) and fatigue (3.4%, 10/292). No serious adverse reactions associated with vaccination were seen. In addition to the higher incidence of pain at the inoculation sites, rest of the adverse reactions was similar to the simultaneous vaccination group or the individual vaccination groups. One month after the completed immunization process, positive rate and geometric mean concentration(GMC) of the HBsAb were not inferior to that of the hepatitis B vaccine group (94.2% vs. 93.8%, 611.6 WU/ml vs. 745.1 WU/ml). Positive rate and GMC of the HEV IgG were not inferior to that of the hepatitis E vaccinated group (98.8% vs. 100.0%, 11.0 WU/ml vs. 18.0 WU/ml). Conclusions Simultaneous vaccination strategy on hepatitis E and hepatitis B vaccines showed good safety and immunogenicity. It is recommended that hepatitis E and hepatitis B vaccines should be administered to the susceptible population at the same time, in order to protect the liver functions.

Objective To investigate the clinical and neuroimaging features of adults with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease at the first attack. Methods We retrospectively analyzed the clinical manifestations,radiological features,laboratory findings,and outcome of 14 adult patients with MOG antibody-associated disease at the first attack who were hospitalized in the departments of neurology of Jiangxi Provincial People's Hospital and Xinyu People's Hospital from January 2018 to January 2022. Results The 14 patients included six males and eight females,with a median age of 29.5 years. The most common initial symptoms were fever and headache (n=5),seizure (n=3),and dizziness (n=3). The supratentorial lesions were located in the thalamus (n=7),subcortical white matter (n=6),cortex (n=5),corpus callosum (n=2), and basal ganglia (n=2). The infratentorial lesions were frequently located in the brainstem:the pons (n=5),middle cerebellar peduncle (n=3),midbrain (n=2), and medulla (n=2). Three patients had spinal cord involvement,with one case of longitudinally extensive transverse myelitis. Thirteen patients had elevated cerebrospinal fluid cell counts,and seven had elevated cerebrospinal fluid protein levels. The serum MOG antibody titer ranged from 1∶3.2 to 1∶512. All the 14 patients received intravenous pulse glucocorticoid therapy. Only one patient had a relapse with optic neuritis. Conclusion In our study,MOG antibody-associated disease showed a slight female predominance and frequently presented as acute disseminated encephalomyelitis. The supratentorial lesions were often located in the thalamus and subcortical white matter,while the infratentorial lesions were frequently in the pons. Intravenous pulse steroid therapy was effecitve in the acute phase. The majority of the patients had a favorable outcome.

Post-stroke insomnia is very common in clinic. Most clinicians regard post-stroke insomnia as common insomnia without considering the particularity of stroke patients. There are many kinds of hypnotics in clinic, and the mechanism and side effects of various hypnotics are different; however, the choice of drugs for post-stroke insomnia is entirely based on experience, and the curative effect is different. This review describes the drug selection of post-stroke insomnia.

Objective: To understand the incidence and mortality of colorectal cancer in tumor registration areas of Zhejiang Province,and to provide reference for prevention and control strategies for colorectal cancer. Methods: The colorectal cancer data was retrieved from fourteen tumor registries in Zhejiang Province were collected,the incidence rate and mortality rate were calculated and standardized according to the Chinese standard population in 2010 and Segi's world population in 2000. The incidence and mortality of colorectal cancer in different sex,age group and region were analyzed. Results: The crude incidence rate of colorectal cancer from 2010 to 2014 was 35.82/100 000（20 983 cases）. The standardized incidence rate by Chinese and world standard population were 20.80/100 000 and 23.01/100 000. The crude mortality rate of colorectal cancer was 15.25/100 000 （8 934 cases）. The standardized mortality rate by Chinese and world standard population were 8.01/100 000 and 9.39/100 000. The ratio of mortality to incidence was 0.43:1. From 2010 to 2014,the incidence and mortality rates of colorectal cancer were stable（P>0.05）. The incidence rates of colorectal cancer in urban and rural residents were 37.69/100 000 and 31.14/100 000,and the mortality rates were 15.73/100 000 and 14.05/100 000. The incidence rates of colorectal cancer in males and females were 41.53/100 000 and 30.11/100 000,and the mortality rates were 17.74/100 000 and 12.76/100 000. The incidence and mortality rates of colorectal cancer both increased with age. The incidence rate increased significantly in people after 40 years old,and peaked with 187.35/100 000 in people aged 80-84 years. The morbidity rate peaked with 171.27/100 000 in people aged 85 years or over. Conclusion The incidence and mortality of colorectal cancer in Zhejiang Province were stable,but the incidence was higher than the national average level. The incidence of colorectal cancer in people aged over 40 years increased significantly.

To investigate the effect of ursolic acid on the invasion and migration of hepatocellular carcinoma (HCC) cells co-cultured with macrophages, and to explore the underlying mechanisms.
 Methods: The migration and invasion ability of HCC cells in the co-culture system with or without ursolic acid intervention were evaluated by transwell assay. The levels of epithelial-mesenchymal transition (EMT) markers E-cadherin, N-cadherin, and vimentin in HCC cells co-cultured with macrophages were detected by Western blot.
 Results: The migration and invasion ability and EMT were significantly enhanced when co-cultured with macrophages, and the expression of E-cadherin was significantly increased while N-cadherin and vimentin levels were significantly decreased. However, after ursolic acid treatment, the migration and invasion ability were significantly reduced, and the expression of E-cadherin was increased while N-cadherin and vimentin levels were decreased.
 Conclusion: Ursolic acid exerts inhibitory effect on the ability of migration, invasion, and EMT for HCC, which are enhanced by co-culturing with macrophages.
Cadherins ; genetics ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Coculture Techniques ; Epithelial-Mesenchymal Transition ; Gene Expression Regulation, Neoplastic ; drug effects ; Humans ; Liver Neoplasms ; pathology ; Macrophages ; cytology ; Neoplasm Invasiveness ; pathology ; Triterpenes ; pharmacology

Objective:To explore the mediating effect of self-compassion between family cohesion and loneliness among adolescents.Method:From November to December 2020, a total of 626 adolescents were investigated with the family adaptability and cohesion scale, children loneliness scale and the self-compassion scale short form.Data were analyzed by SPSS 23.0 and PROCESS v 2.16 softwares.The statistical methods included t-test, one-way ANOVA, Pearson correlation analysis and intermediary effect analysis. Results:Compared with girls, boys’ score of family cohesion((63.52±8.47), (65.48±9.07)) was significantly lower but the scores of self-compassion((37.68±5.26), (36.49±5.75)) and loneliness((37.74±10.44), (36.01±10.48)) were significantly higher( t=-2.79, 2.06, 2.70; all P<0.05). There was no significant difference in the scores of family cohesion((63.67±8.71), (64.74±8.85)), self-compassion((37.45±5.71), (36.98±5.49)) and loneliness((36.60±10.52), (36.96±10.49)) between left-behind and non-left-behind children( t=1.29, -0.87, 0.38, all P>0.05). The score of family cohesion of the adolescents from Grade 7 was significantly lower than those of Grade 8, Grade 10 and Grade 11( P<0.01), while the score of self-compassion of the adolescents from Grade 10 was significantly lower than those of Grade 7 and Grade 11(both P<0.01), but the score loneliness of the adolescents from Grade 11 was significantly lower than those of Grade 8 and Grade 10(both P<0.05). Family cohesion(64.50±8.82)was significantly positively associated with self-compassion(37.09±5.54)( r=0.22; P<0.01). Loneliness(36.88±10.49)were significantly negatively associated with self-compassion( r=-0.27, P<0.01) and family cohesion( r=-0.28, P<0.01). The relation between family cohesion and loneliness was partly mediated by self-compassion and the effect of mediation was 20.9%. Conclusion:Family cohesion will not only directly affect the loneliness of adolescents, but also affect loneliness through the mediating effect of self-care.

The Inner Canon of Yellow Emperor （《黄帝内经》） constructs its theoretical system under the influence of the holistic， symbolic， and holographic mental models of traditional Chinese medicine （TCM）. It lays the theoretical foundation of TCM and provides a paradigm for TCM theory construction， serving as an original academic gene and theoretical source for the inheritance and innovation of modern TCM. Based on the theoretical paradigms derived from The Inner Canon of Yellow Emperor， the holistic mental model， the symbolic mental model， and the holographic mental model in shaping nature-human medicine theory， imagery-based theory， and fractal theory， this study revealed that TCM theory relies on the cognitive framework of traditional cultural mental models. On this basis， we proposed that the modern TCM mental model should return to its roots while fostering innovation， integrating tradition with modernity by combining macroscopic with microscopic perspectives， scientific with humanistic cognition， as well as evidence-based research with digital and artificial intelligence technologies. Furthermore， with a future-oriented approach， this paper discussed on the strategies for reshaping the modern TCM mental model from three dimensions of TCM diagnosis and treatment， TCM education， and TCM research， which could not only preserve the traditional clinical thinking characteristics of TCM， but also innovate modern TCM practice.

An intravascular ultrasound-enhanced thrombolysis excitation system with adjustable frequency, amplitude and duty cycle was designed based on FPGA (ZYNQ-7Z020). Firstly, the FPGA generated waveform amplitude binary data based on direct digital frequency synthesis (DDS) technology, and then the data was converted into burst signal through an external daughter card, which included D/A conversion circuit, active low-pass filter, power amplifier circuit and impedance matching circuit. The test results demonstrated that the output waveform reached the target with advantages of simple implementation and flexible control, the peak negative pressure generated from ultrasound transducer was doubled by means of an electrical impedance matching network. In vitro thrombus models were applied to verify the excitation system, it turned out that ultrasound cavitation effect generated could accelerate the penetration of urokinase and increase the thrombolysis rate by about 20%.
Amplifiers, Electronic ; Electric Impedance ; Thrombolytic Therapy ; Ultrasonography ; Ultrasonography, Interventional

This study intends to establish a colorectal cancer(CRC)organoid model,expand and isolate CRC-reactive tumor-infiltrating lymphocytes(TILs),screen tumor-specific T cell receptors(TCRs)and perform functional verification,in order to provide a technological platform and research foundation for the clinical transformation of individualized adoptive T-cell immunotherapy for colorectal cancer.An organoid model derived from colon cancer patient tissues was constructed using in vitro 3D culture techniques,which then subjected to HE staining and immunohistochemistry for detecting morphological characteristics and representative molecular expression.Subsequently,CRC organoids were co-cultured with TILs for sorting reactive TILs using flow cytometry,and the characteristics of reactive TCR clones was analyzed through single T cell receptor gene cloning technology.Furthermore,the function of TCRs was verified through cytotoxicity experiments.Morphological analysis and representative molecules(CK20 and CDX2)expression indicated that there is high similarity between colorectal cancer organoids and patient tumors.In the in vitro expanded and cultured TILs,colorectal cancer-reactive T cells with upregulated CD137 expression and increased IFN-γ secretion were screened out successfully,among which TCR2-T cells demonstrated superior tumor reactivity and in vitro tumor killing function.In conclusion,a platform for screening and function validation of reactive TCRs based on CRC-Org has been established,providing a technological platform for the translational application of individualized T-cell therapy for colorectal cancer.