This study performed to determine whether OX40L overexpressed by recombinant rabies virus(LBNSE-OX40L)can enhance the innate immune response through activation of dendritic cells and thus activate early antibody production.Bone marrow dendritic cells(BMDCs)were extracted from the femur of Balb/c mice and cultured for 6 days,and the cultured BMDCs were infected with the parental virus LBNSE and the recombinant virus LBNSE-OX40L with the multiplicity of infections(MOI)=1.The effect of each virus on the maturation of BMDCs was analyzed by flow cytometry;ELISA was used to detect the expression of innate immunity-related cytokines such as interferon-α(IFN-α)and interleukin-12p40(IL-12p40)in the supernatants of the infected BMDCs.For in vivo study,Balb/c female mice were injected intramuscularly with 106 FFU of parental virus LBNSE and recombinant virus LBNSE-OX40L in both hind limbs,and the inguinal lymph nodes of mice were collected on day 6 after immunization,and the proportion of mature DCs was detected by flow cytometry.The serum was collected on day 6 after immunization,and the content of virus-neutralizing antibody(VNA)was detected by antiviral neutralizing antibody titration.Mouse serum was collected on day 6 after immunization,and virus neutralizing antibody content was measured by titration of antiviral neutralizing antibody,while IgG antibody in mouse serum was detected by ELISA.IgM antibody subclasses were detected by ELISA on days 2,4,and 6 after immunization.Compared with the parental virus LBNSE,the recombinant virus LBNSE-OX40L was able to activate more BMDCs in vitro and produce significantly higher levels of IFN-α and IL-12p40.Furthermore,the recombinant virus LBNSE-OX40L stimulated the maturation and differentiation of the DCs in vivo,which led to the rapid production of high levels of VNA and RABV-specific IgG and IgM antibodies.Taken together,LBNSE-OX40L activates dendritic cells to promote the body's innate immune response,and in turn enhances early antibody production,thus can be an early effective rabies vaccine candidate.

In traditional clinical teaching of impacted tooth extraction, there are problems including limited observation fields for students, insufficient doctor-patient communication training, inadequate clinical thinking development, and low levels of clinical participation. Based on the core elements of visualizing jaw structure with perspective, formulating clinical strategy, immersing in clinical participation, and cultivating the spirit of caregiving, we developed a virtual reality simulation teaching platform for the clinical decision analysis of impacted tooth extraction. The virtual simulation-based platform can create three different impacted tooth scenarios in 3D, which demonstrates the process of clinical decision analysis of impacted tooth extraction through virtuality-reality interaction, allowing students to immerse in the discovery, analysis, and resolution of the medical and humanistic problems in the process of impacted tooth extraction. The questionnaire survey showed that 81.36% (48/59) of the students believed that the software could improve their clinical thinking ability; 76.27% (45/59) of the students believed that it could help them master the basic process of impacted tooth extraction; and 62.71% (37/59) of the students believed that it could improve their skills of impacted tooth extraction. By providing immersive learning experience, constructive teaching design, and multi-dimensional teaching evaluation, the software achieved the goals of cultivating students' clinical thinking ability and professional literacy in oral and maxillofacial surgery.

Objective:To construct an evaluation index system for the core competence of emergency medical dispatchers, so as to provide a theoretical basis for the training, assessment and ability evaluation of emergency medical dispatchers.Methods:In September 2022, a research group was established to compile the first draft of the evaluation index system for the core competencies of emergency medical dispatchers through literature review, semi-structured interviews and group discussions. From October to November 2022, a total of 27 experts in related fields from nine provinces and municipalities directly under the Central Government in China were consulted by Delphi expert letters, items were screened and amended, and an evaluation index system for the core competence of emergency medical dispatchers was formed.Results:A total of two rounds of correspondence were conducted. The effective recovery rate of the questionnaire was 100%, and the authority coefficient of the experts was 0.856. Kendall's coordination coefficients were 0.402 and 0.414 ( P<0.01), respectively. Finally, a core competency evaluation index system for emergency medical dispatchers was constructed, which included seven primary indicators, 16 secondary indicators and 75 tertiary indicators. Conclusions:The core competence evaluation index system for emergency medical dispatchers is scientific, reliable and comprehensive, which can provide a theoretical basis for the training, assessment and ability evaluation of emergency medical dispatchers.

Objective　To analyze the causes of death of one case of imported falciparum malaria in Guangxi Zhuang Autonomous Region in January 2023, to provide a reference for the prevention of fatal malaria cases. Methods Interviews were conducted with the doctors who received and consulted the patient, as well as the family members of the patient. Clinical data from the patient's diagnosis and treatment process were collected, and the patient's clinical records and epidemiological investigation data were analyzed. Results The patient, Mr. He, a 53-year-old male from Pingnan County, Guigang City, Guangxi Zhuang Autonomous Region, returned from working in Côte d'Ivoire, Africa, and entered Guangxi on December 26, 2022. He returned home after his centralized quarantine was lifted on January 3, 2023. On January 4th, 2023, the patient developed dizziness and vomiting, considering himself to a possible COVID-19 infection, he did not seek treatment. On the morning of January 6, the patient developed a fever (peak body temperature of 40 ℃), accompanied by fatigue and sore throat, and the preemptive symptoms were aggravated. The patient was admitted to the Guancheng Town Health Center with "Pneumonia" and treated with ribavirin, dexamethasone, ceftriaxone sodium, etc. On January 7, the patient again experienced a high fever (40 ℃) and was discharged to the Emergency Department of the First Affiliated Hospital of Guangxi Medical University. Upon admission, the patient's blood pressure was measured at 78/53mmHg, further comprehensive examination showed a decrease in platelets and abnormalities in liver and renal function, procalcitonin levels at 49.9 ng/mL. Chest CT showed pneumonia, and fluid supplements and antibiotics were given. On January 8, malaria parasites were found in the patient's blood smear, and the patient was diagnosed with malaria (not classified, confirmed as falciparum malaria on January 9th). The patient was recommended to transfer to the provincial malaria-designated hospital, but his family refused. On January 8 at 13:27, the patient excreted approximately 700 g of dark red bloody stools accompanied by blurred consciousness and received hemostasis treatment. After coordinating with multiple parties, four doses of "artemisinin injection " (60 mg/dose) were taken for treatment. At 18:59 on January 8, intravenous administration of 60 mg injectable Artesunate was given, accompanied by symptomatic treatment for fever reduction and rehydration. At 19:40, the patient developed severe hypoglycemia, and severe metabolic acidosis, and blood pressure continued to decrease despite the use of vasopressors. After comprehensive treatment at 3:00 am on January 9, the patient's condition continued to deteriorate, the patient's shock could not be corrected, he lapsed into a coma, and the family requested to be discharged from the hospital. The patient returned home at 7:00 am and died of multiple organ failure at 7:30 am. Conclusions For imported malaria, early and precise diagnosis based on epidemiological history, clinical symptoms, laboratory test results, early antimalarial treatment, and management of organ dysfunction are the keys to avoiding fatal outcomes.

Objective:To study disease spectrum and genetic profiles of inborn errors of metabolism (IEM) among newborns in selected areas of Nanning city.Methods:From July 2019 to December 2021, neonates born and received IEM screening in our hospital were prospectively enrolled. Heel blood samples were tested using tandem mass spectrometry as IEM screening. Neonates with positive results were called back for recheck. Whole exome sequencing was used to detect possible pathogenic genes in suspected cases and IEM was diagnosed combining clinical manifestations. Sanger sequencing method was used for the diagnosed neonates and their parents to confirm the diagnoses.Results:A total of 16 207 live-birth neonates were enrolled. For initial IEM screening, 1 423 neonates were positive (8.8%) and 1 311 were called back (92.1%). 15 cases were suspected with IEM and 8 were diagnosed. The overall detection rate was 1∶2 026. Among 8 confirmed cases, 4 cases had amino acid metabolism disorders (2 cases of phenylketonuria, 1 case of Citrin deficiency and 1 case of tyrosinemia), 2 cases had organic acid metabolism disorders (1 case of methylmalonic acidemia and 1 case of glutaric acidemia) and 2 cases had fatty acid oxidation disorders (1 case of carnitine palmitotransferaseⅡdeficiency and 1 case of primary carnitine deficiency). 5 cases had homozygous genetic variants (2 in PAH, and 1 in SLC25A13, SLC22A5 and FAH, respectively) and 3 had heterozygous genetic variants (1 in CPT2, MUT, and GCDH, respectively). During follow-up, all 8 cases had normal growth and developmental outcomes after standardized treatment.Conclusions:The overall detection rate of IEM is high, with varied genetic profiles in selected areas of Nanning. Timely genetic testing may lead to early diagnosis and treatment and improve the quality of life of neonates.

Aluminum is a light metal which is rich in the earth's crust and widely used. Recently, the adverse health effects of environmental and occupational aluminum exposure on human have attracted more and more attention. Aluminum exposure has toxic effects on the central nervous system and is believed to be closely related to the development and progression of Alzheimer's disease. The neurotoxic mechanism of aluminum is complex, especially the role of regulated cell death (RCD) in aluminum-induced neuronal death remains to be further studied. RCD refers to all modes of cell death regulated by multiple intracellular signal transduction pathways under physiological and pathological conditions, including apoptosis, necroptosis, autophagy, pyroptosis, and ferroptosis. This review summarized the morphological characteristics and mechanisms of each RCD mode in the process of aluminum-induced neuronal death, and discussed the relationship and transformation between different RCD modes, providing a new scientific basis for future studies on the treatment and intervention of neurotoxicity induced by aluminum exposure.

Objective: To explore the improvement effect of hypnotherapy on dysmenorrhea symptoms of female college students with primary dysmenorrhea, in order to provide reference for the intervention and treatment of female college students with primary dysmenorrhea. Methods: From Septerber to December 2021, 90 female college students diagnosed with primary dysmenorrhea in Qinzhou First People s Hospital were randomly divided into hypnotic suggestion group( n =30), hypnotic relaxation group ( n =30) and control group( n =30). The 10 session hypnotic suggestion and 10 session hypnotic relaxation interventions were carried out while the control group received no intervention. Participants in the three groups were assessed by using the Visual Analogue Scale(VAS), Beck Depression Inventory Ⅱ(BDI Ⅱ), State Anxiety Inventory(SAI), Questionnaire of Quality of Life of College Students(QOLCS), Cox Dysmenorrhea Symptom Scale (CMSS) before and after intervention. Results: After intervention, the VAS, BDI Ⅱ and SAI scores of the hypnotic suggestion group and the hypnotic relaxation group significantly decreased compared to those before the intervention( t =7.04, 13.32, 3.58, 2.15, 2.52, 2.01, P <0.05). There were statistically significant differences in VAS, BDI Ⅱ and SAI scores among the three groups( F =24.71, 29.57, 6.60, P <0.01). After intervention, the QOLCS total score, physical, psychological and behavioral dimension scores in the hypnotic suggestion group and the hypnotic relaxation group significantly improved( t =-4.61, -3.36, -3.12, -2.81, -2.71, -2.19, -2.69, -2.28, P <0.05). There were statistically significant differences in QOLCS total score, physical, psychological, behavioral, environmental, and social support dimension scores among the three groups( F =10.36, 4.14, 5.14，4.81, 7.07, 5.53, P <0.05). After the intervention, the CMSS dysmenorrhea severity and dysmenorrhea duration scores in the hypnotic suggestion group and the hypnotic relaxation group were significantly lower than those before the intervention( t =5.66, 4.70, 3.09, 2.21, P <0.05). There were significant differences in CMSS dysmenorrhea severity and dysmenorrhea duration scores among the three groups( F=15.33, 12.33, P <0.05). Conclusion Hypnotherapy can help relieve pain of female college students with primary dysmenorrhea，improve depression and anxiety.

Objective: To investigate the effect of hypnotherapy on improving pain degree,pain catastrophizing,pain self efficacy,coping styles of female college students with primary dysmenorrhea, and to provide the theoretical support for psychological intervention. Methods: Fifty six female college students with primary dysmenorrhea were randomly divided into experimental group( n =28) and control group( n =28).Samples in the experimental group received 10 session structured hypnotherapy, while the control group received no intervention (the control group could receive the intervention when the intervention was proved to be effective) .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,was proved to be effective .The effects were evaluated with Numerical Rating Scale (NRS),Pain Catastrophizing Scale (PCS),Pain Self Efficacy Questionnaire（PSEQ）,Simplified Coping Style Questionnaire（SCSQ）in the pretest，protest and tracking test. Results: The time effect，group effect and time group interaction on the NRS,PCS,PSEQ scores of the two groups of female college students were all statistically significant ( F =12.83，21.77，13.65； 22.96，28.98，24.84；25.35，18.26，27.02， P < 0.01 ).Immediately after the intervention and 3 months after the intervention，the scores of SCSQ positive coping dimension of the experimental group（1.43±0.35，1.50±0.39）were significantly higher than those of the control group（1.22±0.19，1.20±0.21），and the scores of SCSQ negative coping dimension of the experimental group（1.59±0.38，1.52±0.49）were significantly lower than those of the control group（1.80±0.17，1.80±0.20）, the differences were all statistically significant ( P <0.05);There were statistical differences among time effect，group effect and timegroup interaction on the positive coping and negative coping scores of SCSQ ( F = 15.14 ， 4.29 ， 14.37 ；7.66，4.10，6.95， P <0.05). Conclusion Hypnotherapy intervention for female college students with primary dysmenorrhea can effectively alleviate pain degree，and improve the pain catastrophizing and coping styles,enhance their pain self efficacy. The hypnotherapy also shows long term effects.

Objective In patients with non -small cell lung cancer(NSCLC)undergoing radical surgery,there were still many inevitable recurrences and distant metastases,even after systemic postoperative adjuvant chemotherapy.At the same time,many patients were in the stage Ⅳ at the time of initial treatment.The aims of this study were to investigate and compare the first-line chemotherapy(First-line Chemotherapy at Recurrence Post-adjuvant Chemotherapy,FCRPC)in NSCLC patients with distant metas-tasis after adjuvant chemotherapy with initial treatment at the phase Ⅳ of NSCLC patients with first-line chemotherapy(Initial First-line Chemotherapy,IFC).Methods A total of 603 patients with distant metastatic NSCLC were collected in this study.Among them,73 of them were FCRPC and 530 of them for IFC.Statistical methods for propensity score matching were used to balance the clinical features between FCRPC and IFC groups.Chi-square test was used to compare the short-term efficacy between FCRPC and IFC groups.Survival analysis was performed using regression analysis and Kaplan-Meier analysis.Results There was no significant difference in objective response rate(ORR)and disease control rate(DCR)between FCRPC and IFC groups in NSCLC patients with dis-tant metastases(ORR rate:27.46% in the FCRPC group,24.7% in the PFC group,P=0.851 and DCR rate:78.1% in the FCRPC group,65.6% in the PFC group,P=0.140).There was also no significant difference in the median progression-free survival(9.8 months in the FCRPC group and 8.5 months in the PFC group,P=0.337)and median overall survival(20.0 months in the FCRPC group and 14.4 months in the PFC group,P=0.087).Conclusion There is no significant difference in the prognosis of first-line chemotherapy between NSCLC patients with distant metastases and with initial treatment at the stageⅣafter adjuvant chemotherapy.

Objective To investigate the effects of methycobal on the expression of Caspase-3 in brain tissue after cerebral ischemia reperfusion in rats. Methods Rats were randomly divided into sham-operation group, model control group, nimodipine group and low-dose methycobal group, high-dose methycobal group(n=30 in each group).Rats in the sham-operation group and model control group were administered intragastrically with 0.9% sodium chloride solution, rats in the nimodipine group were treated with 1 mg . kg-1 . d-1 of nimodipine, rats in the low- and high-dose of methycobal groups were given 50 and 100 μg.kg-1 .d-1 of methycobal, respectively. The rat model of cerebral ischemia reperfusion was established by middle cerebral artery occlusion with suture method for 3 h.Neurological deficit scores were evaluated 24 h after reperfusion.The apoptosis of perifocal cortex cells was detected by TUNEL method and the expression of Caspase-3 was analyzed by RT-PCR 6, 12 and 24 h after reperfusion. Results Neurological deficit scores in model control group, nimodipine group, low-dose methycobal group and high-dose methycobal group were 2.70±0.52, 1.30±0.51, 2.20±0.75 and 1.30±0.81, respectively.Compared with model control group, neurological deficit scores were significantly different in the nimodipine group, low-dose methycobal group and high-dose methycobal group(P<0.05 or P<0.01).There were no significant differences between the high-dose methycobal group and nimodipine group ( P>0. 05 ) . There was a significant difference between the high-dose methycobal group and low-dose methycobal group( P<0. 05 ) . The results of apoptosis by TUNEL were as follows: compared with model control group, the apoptosis decreased obvsiouly in the nimodipine group, low-dose methycobal group, and high-dose methycobal group at each time point.There was significant difference between the high-dose methycobal group and nimodipine group at the end of the 24th hours (P<0.01).Compared with low-dose methycobal group, there were significant differences in the high-dose methycobal group at the end of 6th, 12th and 24th hours(P<0.01 or P<0.05).The results of RT-PCR were as follows: there was expression of caspase-3 mRNA in the perifocal cortex of all groups, with weak expression in the sham-operation group.Compared with the sham-operation group, the expression of caspase-3 mRNA was increased significantly in the model control group(P<0.01).The expression of caspase-3 mRNA was reduced significantly in the nimodipine group, the low-dose methycobal group and high-dose methycobal group as compared with model control group at each time point( P<0.05 or P<0.01) , but it was not significantly different in the low-dose methycobal group and high-dose methycobal group as compared with that of the nimodipine group(P>0.05).There were significant differences between the high-dose methycobal group and low-dose methycobal group at the end of 24 h(P<0.05). Conclusion Methycobal can protect the brain cells from injury after cerebral ischemia reperfusion by adjusting the expression of Caspase-3m RNA, and the high-dose methycobal is more effective.