An offline silver-impregnated silica gel solid-phase extraction (Ag-SPE) approach combined with a programmed temperature vaporization-gas chromatography-flame ionization detector (PTV-GC-FID) was proposed for routine analysis of mineral oil saturated hydrocarbons (MOSH) in chocolates. The MOSH in chocolates were extracted by n-hexane and 1 mL of extract was purified by offline Ag-SPE column. The SPE columns packed with 0.3％ Ag-activated silica gel were used to separate MOSH from triglycerides and olefins in chocolates. The eluent of MOSH fraction was only 5 mL and then concentrated to 0.2 mL through nitrogen blowing with little evaporation loss. The PTV parameters were as follows: the initial temperature was set at 45℃ and held for 1 min (split ratio was 200∶1), then warmed up to 360℃ at linear gradient of 250℃ minSymbolm_1 and held for 27 min (split valve was closed for 2 min followed by split ratio of 100∶1). The GC injection volume was 40 μL. The GC column was heated from 35℃ (3 min) to 350℃ at 25℃/min, and then raised to 370℃ (10 min) at 5℃/min. The flow rate of the carrier gas was 1.3 mL/min (and pressure was 60 kPa), FID temperature was set at 380℃. The limit of quantification (LOQ) and the recoveries of the method were 0.5 mg/kg and 84.9％-108.6％, respectively, with the relative standard deviations (RSD) of 0.2％-1.5％. Twenty-five commercial chocolate samples were analyzed with the proposed method, and it was found that the MOSH in three samples were not detected, and the concentrations of MOSH in other 22 samples were 1.09-8.15 mg/kg (the concentrations of MOSH with C16-C35 component were 0.56-4.43 mg/kg). The results suggested that it was necessary to routinely detect mineral oil contamination in chocolates for food safety.

Objective: To investigate the effect of human chorionic gonadotrophin (hCG) on the gene expression of migration inhibitory factor (MIF) in human peripheral blood mononuclear cell (PBMC). Methods: The healthy human PBMC was cultured with hCG at 37 ℃, 5%CO_2 for 2 hours. The mRNA of harvested cells was isolated. The MIF mRNA was detected by real-time RT-PCR. Results: In a certain range of doses, the mRNA expression of MIF significantly increased following the increase of hCG in a dose depandent manner, and it reached to a peak 1-2 hours after culture, then returned to the minimum level after 8 hours. Conclusion: In a certain range of doses, hCG can increase the mRNA expression of MIF. This effect is correlated with reacting time. It is suggested that hCG may involve in immune response by up-regulating the production of cytokines by PBMC.

In this review,we have briefly described the case-based learning about its history,development,characteristics,effect,status quo at home and abroad,the problem in the application in our country.More,we have focused on how the case-based learning is carried out and what the scope is in midwifery both domestic and overseas,the aim is to promote the reform of the midwifery in China and to train qualified midwives.

Objective To investigate the clinical features and treatment of residual gallbladder lesions after cholecystectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 83 patients with residual gallbladder lesions after cholecystectomy who were admitted to the Affiliated Hospital of Inner Mongolia Medical University between January 2009 and April 2016 were collected.Among the 83 patients,74 had residual gallbladder (41 combined with bile duct stones and 33 with simple residual gallbladder)and 9 had simple residual bile duct stones.Patients received laboratory and imaging examinations,and then selected suitable surgery according to residual lesions.Observation indicators included:(1) clinical features:medical history,clinical manifestation,features of laboratory and imaging examinations;(2) surgical and postoperative situations:surgical procedure,operation time,volume of intraoperative blood loss,time of drainagetube removal,postoperative complications and duration of postoperative hospital stay;(3) postoperative pathological examination;(4) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and recurrence of lesions using abdomen color Doppler ultrasound up to October 2016.Measurement data with normal distribution were represented as ~ ±s.Results (1) Clinical features:① medical history:all the 83 patients had histories of cholecystectomy,including 57 with emergency operation and 26 with selective operation.② Clinical manifestation:initial clinical manifestation occurred at 1-324 months postoperatively,with an average time of 96 months.Of 83 patients,49 had right upper abdominal colic associated with right shoulder or back rediating pain,fever,nausea and vomiting,24 had jaundice as the main symptoms,8 had gradually worse conditions,with right upper quadrant abdominal pain,chills and fever associated with jaundice in the advanced stage and 2 had abdominal discomfort associated with incomplete intestinal obstruction.③ Laboratory examination:elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels were detected in 48 patients,elevated total bilirubin (TBil) level in 28 patients and elevated serum and urinary amylase level in 4 patients,respectively.④ Imaging examination:of 83 patients,77 had positive results of magnetic resonanced eholangio-pancreatography (MRCP),43 had positive results of abdominal color Doppler ultrasound and 39 (4 combined with pancreatitis) had positive results of abdominal computed tomography (CT).(2) Surgical and postoperative situations:all the 83 patients underwent surgery.Of 74 patients with residual gallbladder,72 underwent residual gallbladder resection (of 41 combined with bile duct stones,35 undergoing residual gallbladder resection + bill duct exploration and removing the stone + T-tube drainage,6 initially undergoing endoscopic sphincterotomy for removing bile duct stones and then residual gallbladder resection and 31 undergoing simple residual gallbladder resection),1 combined with residual gallbladder cancer underwent residual gallbladder resection + common bile duct resection + hepatic duct-jejunum internal drainage and 1 combined with residual gallbladder cancer and common bile duct space-occupying lesion underwent palliative biliary-enterostomy.Nine patients with simple residual bile duct stones underwent endoscopic sphincterotomy for removing bile duct stones.Operation time,volume of intraoperative blood loss,time of drainage-tube removal and duration of postoperative hospital stay were (92±39)minutes,(63±12)mL,(5±4)days and (9±5)days in 74 patients with residual gallbladder,respectively.There was no severe postoperative complication.Operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were (57±33)minutes,(25±9)mL and (5 ± 3) days in 9 patients with simple residual bile duct stones,respectively.No severe complication was occurred in 9 patients.(3) Postoperative pathological examination:the length of residual cystic duct in 74 patients with residual gallbladder was (2.8 ± 1.0) cm,combining with stones.Of 74 patients,simple hyperplasia of residual gallbladder were detected in 54 patients,dysplasia in 14 patients,tumor-like hyperplasia and benign tumor in 4 patients and adenocarcinoma in 2 patients.(4) Follow-up situation:all the 83 patients were followed up for 6-71 months,with a median time of 33 months.Eighty-one patients were healthy survival,without recurrence of lesions.One patient had recurrence of bile duct stones at 34 months postoperatively,and then was cured by choledochojejunostomy,without recurrence up to the end of follow-up.One patient with residual gallbladder cancer complicated with common bile duct space-occupying lesion died at 9 months postoperatively.Conclusions Patients have recurrent right upper abdominal colic associated with right shoulder or back rediating pain,fever and jaundice after cholecystectomy,and lesions of residual gallbladder or bile duct stones should be considered.Reoperation is safe and feasible for patients,with a good clinical outcome.

OBJECTIVETo explore the prevalence of syphilis and HSV-2 among female sex workers (FSWs) who use new types of drugs in Jiaozhou city.

METHODSThrough convenient sampling, an anonymous questionnaire survey was conducted among female sex workers to collect demographic characteristics, new-type drugs abusing characteristics and related sexual behaviors from October to December, 2013. Blood specimens were drawn for serological tests of syphilis antibody and HSV-2 antibody. Urine specimens of the subjects surveyed were collected to test for methamphetamine. Differences in demographic characteristics, new-type drug abusing characteristics, and sexual behaviours between drug-abusing FSWs and non-drug-abusing FSWs were compared by t-test and χ(2)-test.

RESULTSA total of 460 FSWs were recruited in this study, and 105 FSWs admitted their drug abuse history. Among the 341 urine specimens confirmed to be methamphetamine positive, there were 3 FSWs claimed that they never abuse new-type drugs. The rate of new-type drug abuse was 23.5% (108/460). A total of 71.4% (75/105) of the new drug-abusing FSWs started using drugs under 25 years old. The main reasons for drug abuse were clients request (24, 22.9%), making more money (23, 21.9%) and companion temptations (22, 21.0%). Totally, 41.9% of them (44/105) took drugs with 4-5 persons, 32.4% (34/105) had sex with 2-3 men after taking drugs, and 60.2% of new-type drug-abusing FSWs (65/108) used condoms in the latest commercial intercourse, while only 7.4% FSWs (8/108) used condoms every time during their commercial sex activities in the recent month. Compared with FSWs having no drug abuse behavior, drug-abusing FSWs had higher single proportion (73.2% (79/108) vs 63.6% (224/352), χ(2) = 8.64, P < 0.05), lower condom use rate in the recent month (7.4% (8/108) vs 22.7% (80/352), χ(2) = 12.53, P < 0.01) and higher pregnancy rate in the recent 6 months (24.1% (26/108) vs 8.8% (31/352), χ(2) = 17.74, P < 0.01) and most of them come from the middle and high-level entertainmens (78.7% (85/108) vs 65.1% (229/352), χ(2) = 13.09, P < 0.01). Among the new-type drug-abusing FSWs, the prevalence rates of syphilis and HSV-2 were 12.0% (13/108) and 55.6% (60/108) , respectively. A total of 33 FSWs claimed that they were diagnosed with STDs in the recent year (30.6%) . The rates of syphilis(12.0% (13/108) vs 4.0% (14/352), χ(2) = 9.72, P < 0.01), HSV-2(55.6% (60/108) vs 39.2% (138/352), χ(2) = 9.01, P < 0.01) and diagnosed STDs (30.6% (33/108) vs 17.9% (63/352), χ(2) = 8.02, P < 0.01) among the drug-abusing FSWs were significantly higher than those of non-drug-abusing FSWs.

CONCLUSIONThere is a higher proportion of new-type drug abuse among the FSWs in Jiaozhou, with significantly higher prevalence rates of syphilis and HSV-2 infection, compared with non-new types of drug abusing FSWs. Prevalent risk sexual behaviors and ignorance of new-types drugs' harm were seen among them.

China ; epidemiology ; Condoms ; Designer Drugs ; Female ; Herpes Genitalis ; epidemiology ; Herpesvirus 2, Human ; Humans ; Methamphetamine ; Pregnancy ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; Sex Workers ; statistics & numerical data ; Sexual Behavior ; drug effects ; statistics & numerical data ; Sexual Partners ; Substance-Related Disorders ; Syphilis ; epidemiology

Objective: To analyze the epidemiological characteristics of occupational diseases in Gansu Province, China in 2010-2017, and to provide a scientific basis for the prevention and control of occupational diseases. Methods: The cluster sampling method was adopted to make statistical analysis of 1339 cases of occupational disease reported by "occupational disease and occupational health information monitoring system" in Gansu province from 2010 to 2017, to investigate the diseases, regions and industries of occupational diseases in June 2018. Results: A total of 1339 cases of occupational diseases (39 types, 8 classes) were diagnosed and reposed in 2010-2017. The three most frequent diseases were pneumoconiosis (87.53%, 1172/1339), occupational poisonings (5.83%, 78/1339), and occupational ear, nose, and throat (ENT) diseases (3.14%, 42/1339). The cases of silicosis accounted for 54.61% (640/1172) of all cases of pneumoconiosis, the second was coalworker pneumoconiosis, which accounted for 38.57% (452/1172). In the cases of occupational poisonings, 32.05% (25/78) suffered from carbon monoxide poisoning. Patients with occupational diseases were reported in 14 districts of Gansu, mostly in Lanzhou (27.52%, 347/1261), Jinchang (16.57%, 209/1261), and Baiyin (14.20%, 179/1261). The reported cases are mainly concentrated in mining (71.56%, 468/654) and manufacturing (21.87%, 143/654), the types of state-owned economy (55.63%, 692/1244) and private economy (33.68%, 419/1244), large (43.41%, 540/1244) and small enterprises (35.21%, 438/1244) in 2010-2017 in Gansu. Conclusion The pneumoconiosis caused by silicious and coal dust and the occupational poisonings caused by carbon monoxide seem to be the main occupational hazards in Gansu province. Occupational diseases occur in all districts of Guangzhou and in various industries. The state-owned economy and private sector, large and small enterprises should be the focuses of occupational health supervision.

Objective To analyze the influencing factors on condom use among 35-yearsor-older female sex workers (OFSWs) in Qingdao by using the three-level logistic model.Methods From March to June 2014,OFSWs were recruited in Qingdao,using respondent-driven sampling.Related information on OFSWs and their recent five sexual partners (not including husband) were obtained by conducting a questionnaire survey on OFSWs.A Three-level logistic regression model was conducted to analyze the influencing factors of condom use between OFSWs and their sexual partners.Results A total of 420 OFSWs participated the survey as well as information on 2 100 sexual partners.Results from the empty model showed that the use of condoms among OFSWs having an aggregation that related to the levels of working sites and their own behaviors.Results from the three-levels of logistic model analysis showed that,OFSWs that having had junior middle school education (OR=1.450,95％CI:1.054-1.994)/high school education or above (OR=2.264,95％ CI:1.215-4.222),knowing the function of condom use (OR=2.004,95％ CI:1.273-3.154) would have higher rates of condom use.OFSWs with higher score of attitude on condom use (OR=0.796,95％CI:0.745-0.849),having had syphilis infections in the past (OR=0.657,95％ CI:0.478-0.902) would have lower rate of condom use.For the sexual partners,the rate of condom use among OFSWs' regular partners were higher than that of OFSWs' boyfriends (OR=15.291,95％CI:8.441-27.700;OR=29.032,95％ CI:15.413-54.682).Conclusion Condom use of OFSWs was affected by behaviors of both OFSWs themselves and their sexual partners.Prevention and control programs should focus on OFSWs and their sexual partners at the same time.The key intervention contents should include target populations as:OFSWs with low level of education,having had infections of syphilis,those who do not use condoms with their trusted partners.

Objective:To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods:Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group. An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group. Clinical efficacy, postoperative complications and postoperative pain were compared between the two groups.Results:Postoperative fasting time, length of hospital stay, and total hospital days in the observation group were 6 (6, 6) hours, 2 (2, 3) days and 4 (4, 6) days respectively, which were significantly shorter than 24 (24, 36) hours, 5 (5, 6) days, 7 (7, 9) days in the control group ( H = 351.00, 407.50, 458.00, all P < 0.05). Hospitalization cost in the observation group was 5 454.58 (5 014.11, 6 016.58) yuan, which was significantly lower than 6 611.91 (6 192.68, 7 841.73) yuan in the control group ( H = 420.00, P < 0.05). There were no significant differences in operative time and postoperative complications between the two groups (both P > 0.05). At postoperative 6 hours, Visual Analogue Scale score in the observation group was 3 (3, 4) points, and patients with mild pain accounted for 73.07% (19/26). At postoperative 24 hours, Visual Analogue Scale score in the observation group was 2 (2, 3) points, and patients with mild pain accounted for 92.31% (24/26). Overall pain was well controlled after surgery. Patient satisfaction rate in the observation was 96.15% (25/26). All patients recovered and were discharged. Conclusion:Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery, contribute to changing the theory of diagnosis and treatment, and improve overall medical quality. The enhanced recovery after surgery protocol using the LEER model has a good application value.

Trauma registration is an important tool to record the process and timeline in the treatment of trauma patients. The operation of trauma database is of great significance for reducing the mortality of patients, promoting the construction of trauma treatment system, and providing reference for policy-making. Trauma registration system has been established in the United States, United Kingdom, Germany and other developed countries for many years. However, the domestic system is still at an initial stage, and there are problems like data deficiencies, data incoherence, no item of complications, no treatment data after discharge and limits of human and financial resources. Therefore, there is room for improvements in terms of personnel fixation, financial support and continuous data monitoring should be further improved. In this study, the authors summarize the traum registration system from aspects of basic situation both at home and abroad, data analysis, clinical value, operation mechanism and challenges so as to provide important data for clinical researches.

Isoprenoids are all derived from two five-carbon building blocks called isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP), which are synthesized either by the mevalonate (MVA) pathway or 2-C-methyld-D-erythritol-4-phosphate (MEP) pathway. In this study, the MVA pathway genes were integrated into the chromosome of LYC101, in which the expression of key genes in the MEP synthesis pathway and lycopene synthesis pathway were optimized by artificial regulatory parts, to further improve the production of isoprenoids in Escherichia coli. The plasmids pALV23 and pALV145 were screened from a plasmid library that constructed by using the RBS library to link the genes of the MVA pathway, which greatly increased the production of β-carotene. The effects of plasmids pALV23 and pALV145 on the lycopene production in low and high lycopene production strain, LYC001 and LYC101, were compared, respectively. The production of lycopene was increased by plasmids pALV23 and pALV145 in both strains. In high lycopene production strain LYC101, pALV23 produced more lycopene than pALV145. Then, the MVA gene together of promoter of pALV23 was integrated into the chromosome of LYC101 at poxB site using method of homologous recombination helped by CRISPR-Cas9 system, resulted in genetically stable strain, LYC102. The yield of lycopene of LYC102 was 40.9 mg/g DCW, 1.19-folds higher than that of LYC101, and 20% more than that of LYC101 with pALV23. Simultaneous expression of MVA pathway and MEP pathway in recombinant E. coli can effectively increase the yield of terpenoids. In this study, a plasmid-free, genetically stable, high-yielding lycopene strain was constructed, which could be used for industrialization. Also, the platform strain can be used for the synthesis of other terpenoids.
Chromosomes, Bacterial ; Escherichia coli ; Lycopene ; Mevalonic Acid ; beta Carotene