[Summary] The incidence of diabetes mellitus is increasing year by year ,which attracts more and more attention. Scientific researches have demonstrated the role of chronic systemic inflammation and immune dysregulation in the development of type 2 diabetes mellitus (T2DM ). Moreover ,the evidence of islet autoimmunity has also been identified in some patients with T 2DM. These discoveries highlight the potential of immune‐modulatory therapies for T 2DM.

Objective\ To observe the expression of 5\|HT 1A and 5\|HT 2A receptor mRNAs in the rat spinal cord and dorsal root ganglion(DRG). Methods\ In situ hybridization histochemical technique. Results\ (1)5\|HT\-\{1A\} receptor mRNA positive neurons were found in all laminae of the gray matter,mainly in the superficial laminae(laminae Ⅰ and Ⅱ),laminae Ⅲ and Ⅳ of the dorsal horn.Scattered positive neurons were also observed in laminae Ⅴ\|Ⅶ and Ⅹ.Very few positive signals were found in the ventral horn(lamnina Ⅸ);(2)5\|HT\-\{2A\} receptor mRNA positive neurons were mainly found in the superficial laminae and ventral horn,while sparsely distributed positive neurons were also located in other laminae.Within the DRG:(1)About 10\^4% of the total DRG cells were labeled with 5\|HT 1A receptor mRNA.The positive signals were mainly confined to a subpopulation of small\| and medium\|sized cells;(2)About 17\^4% of the total DRG cells were labeled with 5\|HT 2A receptor mRNA,most of them were also small\| and medium\|sized cells. Conclusions\ 5\|HT 1A and 5\|HT 2A receptor mRNAs positive neurons distributed heterogeneously in the rat spinal cord and DRG, they may play important roles for 5\|HT in the analgesic effects at the spinal level and nociception in the periphery.\;

Objective To investigate molecular types and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in Zhejiang province.Methods One hundred and fourty-seven clinical MRSA isolates were collected from 11 grade A tertiary hospitals during January 2009 and December 2010 in Zhejiang province.Minimal inhibitory concentrations (MICs) of 13 antimicrobial agents were determined by agar dilution.Multilocus sequence typing (MLST),staphylococcal cassette chromosome mec (SCCmec) typing and spa typing were used to examine the homology of the strains,and drug resistance patterns were compared among different molecular types.Simpson index was used to determine the discriminatory power of three typing methods.Results Fourteen STs were identified in 147 MRSA isolates,of which ST239 (75 isolates),ST5 (24 isolates) and ST59 (23 isolates) were the most prevalent clones.Four SCCmec types (types Ⅱ to Ⅴ) were identified in 141 isolates,and 6 isolates were not typed.SCCmec type Ⅲ was the predominant type (76 isolates),which was followed by type Ⅳ (32 isolates),type Ⅱ (24 isolates) and type Ⅴ (9 isolates).All MRSA isolates yielded 23 spa types,in which t030 (57 strains),t437 (17 strains),t002 (15 strains) and t037 (12 strains) were the predominant spa types.MRSA strains were sensitive to linezolid,teicoplanin,vancomycin and norvancomycin,but were highly resistant to other antibacterial agents,especially in strains carrying clone ST239 or of SCCmec type Ⅲ.The discriminatory power of MLST,SCCmec and spa typing were 0.6885,0.6577 and 0.8165,respectively.Conclusion The predominant clone of MRSA strains in Zhejiang province was ST239-SCCmec Ⅲ-t030-MRSA,and these strains are highly resistant to most antibacterial agents,so that the surveillance of MRSA in hospital should be strengthened.

Objective To evaluate the protection of combined clostridium butyricum and bifidobac-terium living powders for antibiotic-associated diarrhea ( AAD ) with all kinds of infections in hospitalized children,and to compare the therapeutic effect with saccharomyces boulardii. Methods This study was a prospective,randomized case-control clinical trial which collected the data of the hospitalized children with all kinds of infections in Pediactric Department of Shengjing Hospital of China Medical University between May 2011 to May 2012. A total of 552 cases were enrolled and 480 cases completed the study. A total of 240 chil-dren were in experimental group,80 cases received combined clostridium butyricum and bifidobacterium liv-ing powders 840 mg per time,twice a day and the other 160 cases received saccharomyces boulardii 250 mg per time,twice a day,for one week; the control group took none of probiltics. Two groups received routine antibiotic therapy. Everyday′s defecate frequency was recorded, the traits of excrement according to bristol stool assessment scale were evaluated,the incidence of diarrhea and drug related adverse reactions were coun-ted. Results During the studied 7 days,the AAD incidence was 4. 2%(10/240) in experimental group and 20. 4%(49/240) in control group,there was significant difference between two groups. The risk of AAD in experimental group decreased 58. 5%. Compared to saccharomyces boulardii,combined clostridium butyricum and bifidobacterium living powders decreased 38. 2% (RR=0. 728, 95%CI 0. 257~0. 784, P=0. 009). Compared to control group,the average defecate frequency decreased in experimental group,diarrhea duration contracted,there was statistic difference between two groups ( P<0. 01 ) . No drug related adverse reactions happened during the trial. Conclusion Both combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii could effectively reduce the risk of AAD in hospitalized children with bacterial infection,relieve diarrhea symptoms,short the duration of diarrhea,and did not find the adverse reac-tions. Combined clostridium butyricum and bifidobacterium living powders and saccharomyces boulardii had the same protective effect for AAD of northern China children.

Objective: To observe the incidence of unreasonable use of high beam at nighttime among motor vehicle drivers, so as to provide the evidence for the prevention and control of road traffic injury. Methods: Four roads into city and five urban roads were selected in Yongkang of Zhejiang Province. An automatic recording system was used to collect the unreasonable use of high beam among motor vehicle drivers on the selected roads from 19:00 to 5:00 on Monday, Wednesday, Friday and Sunday during a week in July 2020. The regression tree model was used to analyze the relationship of the unreasonable use of high beam with road, time and traffic flow. Results: A total of 89 989 motor vehicles were observed, and 2 419 motor vehicle drivers had unreasonable use of high beam, with an incidence rate of 2.69%. The incidence rate of the unreasonable use of high beam was 3.14% in the roads into city, which was higher than 2.30% in the urban roads ( P<0.05 ). The incidence rates of the unreasonable use of high beam in the roads into city and in the urban roads were 5.15% and 2.90% on Wednesday, which were higher than those on Monday ( 2.89% and 2.34% ), Friday ( 2.90% and 1.92% ) and Sunday (2.06% and 2.12%). The highest incidence rate of the unreasonable use of high beam in the roads into city was 6.07% between 4:00 and 5:00, and in the urban roads was 4.50% between 2:00 and 3:00. The results of regression tree classification analysis showed that the highest incidence rate was 8.13% on the roads into city in the east, west and south directions, and on the urban roads in the east and north directions with less than 317 vehicles per hour on Wednesday. Conclusion It is more likely for motor vehicle drivers to use high beams unreasonably at nighttime on the roads into city with less traffic flow.

Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.

Neuropathic pain(NP)is caused by leision or disease of the somatic sensory nervous system,and its pathological mechanism is complex,mainly related to abnormal neural structure and function.It is hard for existing treatment methods to obtain satisfactory results.With the deepening of the study of peroxisome proliferate activation receptor-γ(PPAR-γ),its role in neuroinflammation,oxidative stress,ion channels,mitochondrial function,neuroprotection and other aspects have been discovered succes-sively,PPAR-γ may be one new target for pain prevention and treatment.This paper reviews the role of PPAR-γ in NP and related mechanisms,in order to provide new thinking for the clinical treatment of NP.

Objective To investigate the common allergens in the patients with hand eczema.Methods From November 2014 to March 2016,the patients with hand eczema were tested by the patch test kit of daily life series.Results The results of the patch test of 192 patients with hand eczema were collected.Allergens were detected in 178 (92.71％) cases.The top 5 allergens were nickel chloride (23.96％),cobalt chloride (18.75％),aromatic compounds (17.19％),nickel sulfate (16.67％) and thimerosal (13.54％).The positive rates of kappa mixture,aromatic compounds,tertiary butyl phenolic resin in males were 16.88％,14.29％,11.69％,respectively,which were higher than those (5.22％,4.35％,3.48％) in females.Conclusion Nickel chloride,cobalt chloride,aromatic compounds,nickel sulfate and thimerosal are common allergens in patients with hand eczema.

Objective To investigate the common allergens in the patients with hand eczema.Methods From November 2014 to March 2016,the patients with hand eczema were tested by the patch test kit of daily life series.Results The results of the patch test of 192 patients with hand eczema were collected.Allergens were detected in 178 (92.71％) cases.The top 5 allergens were nickel chloride (23.96％),cobalt chloride (18.75％),aromatic compounds (17.19％),nickel sulfate (16.67％) and thimerosal (13.54％).The positive rates of kappa mixture,aromatic compounds,tertiary butyl phenolic resin in males were 16.88％,14.29％,11.69％,respectively,which were higher than those (5.22％,4.35％,3.48％) in females.Conclusion Nickel chloride,cobalt chloride,aromatic compounds,nickel sulfate and thimerosal are common allergens in patients with hand eczema.

Purpose/Significance To analyze relevant patented technologies,and to provide experience for medical and commercial health insurance institutions to break through the data interaction blocking point and construct a multi-level medical security system.Method/Process The patentometrics method is used to analyze the data interaction patent technology between medical and health insurance institutions from four aspects:time trend,regional distribution,category distribution and text clustering.Result/Conclusion China should pay attention to the role of data interaction in deepening cooperation between medical and insurance institutions,improve the declaration,authorization,application and protection of high-quality patents,pay attention to cross-border integration and technology-driven,and innovate patent layout to meet technological development and social needs.