Objective:To explore the independent risk factors for the occurrence and aggravation of lower back pain (LBP) in patients with Parkinson′s disease (PD), in order to provide reference for clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the case data of 309 PD patients who visited the Affiliated Yixing Hospital of Jiangsu University from June 2018 to May 2020. The KING Parkinson′s Disease Pain Scale (KPPS) was used to quantitatively evaluate the LBP of PD patients, who were divided into LBP group and Non LBP group. The general clinical data, PD related data, and imaging data of the two groups were compared and analyzed. Binary logistic regression analysis was used to evaluate independent risk factors for LBP in PD patients. Pearson correlation analysis was conducted between KPPS scores and various factors, and linear regression analysis was used to identify the relevant risk factors that exacerbate LBP in PD patients.Results:Compared with the Non LBP group, the LBP group had lower bone mineral density (BMD) and a lower proportion of patients who engaged in daily exercise. The difference between the two groups was statistically significant (all P<0.05). Compared with the Non LBP group, patients in the LBP group had a longer course of illness, higher stiffness scores, a higher proportion of patients with fluctuating symptoms, higher UPDRS-Ⅲ scores, and a higher proportion of patients with thoracolumbar fascial injury (TLFI) and lumbar sagittal imbalance. The differences between the two groups were statistically significant (all P<0.05). The results of binary logistic regression analysis showed that combined TLFI ( OR=2.773, 95% CI: 1.219-6.309, P=0.015), combined lumbar sagittal imbalance ( OR=4.835, 95% CI: 2.244-10.421, P<0.001), and lower BMD ( OR=2.818, 95% CI: 1.767-4.493, P<0.001) were risk factors for LBP in PD patients. The KPPS score was correlated with BMD and TLFI ( r=-0.146, 0.294, all P<0.05). The linear regression results showed that the merged TLFI ( B=2.271, β=0.285, P<0.001) was positively correlated with KPPS score, indicating a risk factor. Conclusions:The combination of TLFI, lumbar sagittal imbalance, and lower BMD is closely related to the occurrence of LBP in PD patients, and the combination of TLFI is an independent risk factor for exacerbating LBP symptoms. Clinical attention should be paid to the prevention and treatment of TLFI in PD patients.

Objective:To summarize the application and effect of "Trinity" emergency chain in the management of patients with epidemic respiratory tract infection under the cooperation of multiple hospitals and districts, and to provide a reference for medical institutions to improve the risk response ability.Methods:Based on the collaborative management of multi-branches, the "Trinity" emergency chain of pre-hospital-emergency-critical care, identification-triage-treatment, expansion-training-dispatch was implemented to optimize and integrate medical resources.Results:During the two months, 43,000 patients were admitted to the fever clinic, with an increase of 36.08%. The average waiting time for treatment was 19.83 min, and the average admission time to ICU was 25.35 min.Conclusions:The "Trinity" emergency chain treatment scheme under the coordination of multi-branches can effectively deal with the public health events of respiratory tract infectious diseases, improve the efficiency of rescue and treatment, and enhance the risk response ability of medical institutions.

Objective: To investigate the spatio-temporal clustering characteristics of influenza in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2021, so as to provide insights into prevention and control of influenza. Methods Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Methods: Data of influenza in Yinzhou District from 2017 to 2021 were collected from the Chinese Disease Prevention and Control Information System. The software ArcGIS 10.8 was employed for spatial autocorrelation analysis, and SaTScan 10.1 was employed for spatio-temporal scanning to analyze the temporal and spatial clustering characteristics of influenza incidence in Yinzhou District. Results: Totally 60 543 influenza cases were reported in Yinzhou District from 2017 to 2021, with an incidence of 0.76%. The incidence of influenza peaked in December 2019 (9.35%) and January 2020 (9.28%) during the period between 2017 and 2021. Spatial autocorrelation analysis showed that there was a positive spatial correlation of influenza incidence in Yinzhou District from 2018 to 2021 (all P<0.05), and a high clustering in 2019 and 2021. Zhonghe Street showed a low-high clustering from 2017 to 2020; Jiangshan Town showed a low-high clustering in 2017 and 2020, and a high-high clustering in 2019 and 2021; Shounan Street showed a high-high clustering from 2018 to 2020; Yunlong Street showed a high-high clustering in 2021. Spatio-temporal scanning analysis showed that the class Ⅰ clusters were located in the central region which centered in Dongqianhu Town, with aggregation time in August 2017, in the northwest region with aggregation time in December and January from 2018 to 2020, and in the west region with aggregation time in August 2021. Conclusion The incidence of influenza in Yinzhou District from 2017 to 2021 showed a spatio-temporal clustering in the northwestern region in winter and summer.

In order to standardize the review and comment of national key monitoring drug prescriptions （medical orders） by medical institutions at all levels， the Sichuan Academy of Medical Sciences·Sichuan Provincial People’s Hospital took the lead in compiling the Review and Comment Rules of National Key Monitoring Drugs prescriptions （Medical Orders） herein after referred to as the Rules in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as the List） issued by the National Health Commission confirmed in Jan. 13， 2023. According to the laws and drug instructions issued by the national drug regulatory department， clinical guidelines and expert consensus， combined with the actual situation of patients （including age， body weight， liver and kidney function）， the writing group classified the common and unreasonable drug use problems for 30 kinds of drugs included in the List and develop the review and comment details. After two rounds of Delphi method questionnaire research and experts’ online meetings， and reviewed by the steering committee， the final Rules was formed. The Rules aim to provide reference for the evaluation of the rational use of drugs included in the List by medical institutions， so as to realize the standardized management of key monitoring drugs， promote the rational drug use in medical institutions， and ensure the safety of drug use for patients.

Single-cell or low-input multi-omics techniques have revolutionized the study of pre-implantation embryo development.However,the single-cell or low-input proteomic research in this field is rela-tively underdeveloped because of the higher threshold of the starting material for mammalian embryo samples and the lack of hypersensitive proteome technology.In this study,a comprehensive solution of ultrasensitive proteome technology(CS-UPT)was developed for single-cell or low-input mouse oocyte/embryo samples.The deep coverage and high-throughput routes significantly reduced the starting material and were selected by investigators based on their demands.Using the deep coverage route,we provided the first large-scale snapshot of the very early stage of mouse maternal-to-zygotic transition,including almost 5,500 protein groups from 20 mouse oocytes or zygotes for each sample.Moreover,significant protein regulatory networks centered on transcription factors and kinases between the MII oocyte and 1-cell embryo provided rich insights into minor zygotic genome activation.

Objective To explore whether inhibiting autophagy can enhance the sensitivity of photothermal treatment under mild photothermal conditions. Methods CQ@PLGA@PDA NPs were prepared by an improved double emulsification method and a PDA-based surface modification method. After basic characterization, CCK-8 method was used to detect the cytotoxicity of nanoparticles; the near-infrared laser irradiation nanoparticle solution was used to detect the heating effect; CCK-8 method and live-dead cell staining were used to detect the killing effect of tumor cells; Western blot was used to detect the expression of autophagy-related proteins. Results The CQ@PLGA@PDA NPs were successfully prepared, with a particle size of 253.10±2.39 nm, a zeta potential of -22.57±0.80 mV, uniform particle size and good dispersion. The temperature of nanoparticle solution increased to 45℃ after the near-infrared laser irradiation for 10 min. CQ@PLGA@PDA NPs had no obvious toxicity to cells. The survival rates of breast cancer cell MDA-MB-231 and mouse embryonic fibroblast NIH-3T3 cell were above 95%. The inhibition of autophagy under mild photothermal conditions could improve the sensitivity of photothermal therapy. Conclusion The prepared CQ@PLGA@PDA NPs have good photothermal performance and high biological safety; by inhibiting autophagy, they can effectively kill tumor cells under mild photothermal conditions(< 50℃).

Objective:To explore the effect of drug combined with CO2 laser minimally invasive surgery in the treatment of patients with vascularized vocal cord inflammation, and the influence on the voice function of patients.Methods:From April 2018 to July 2019, 74 patients with vascularized vocal cord inflammation admitted in the Affiliated Hospital of Yangzhou University were divided into two groups according to the random number table method, with 37 cases in each group.The patients in the control group were treated with oral medicine.The patients in the observation group were treated with medicine combined with CO 2 laser minimally invasive surgery.The voice quality, improvement of voice disorders, recurrence and patients' satisfaction were observed. Results:After treatment for 12 months, the total hoarseness(G), roughness(R) and breath(B) scores in the observation group were (1.60±0.13)points, (1.71±0.21)points and (1.42±0.12)points, respectively, which were significantly lower than those in the control group [(1.88±0.16)points, (1.98±0.10)points and (1.78±0.13)points] ( t=8.262, 7.061, 12.377, all P<0.05). After treatment, the functional, physiological and emotional scores of voice disorders index(VHI) and total score in the observation group were (10.10±1.03)points, (13.26±2.10)points, (7.30±1.10)points, (31.26±4.74)points, respectively, which were significantly lower than those in the control group [(11.63±2.16)points, (15.42±2.16)points, (8.86±1.05)points, (35.86±5.33)points] ( t=3.889, 4.361, 6.240, 19.103, all P<0.05). The recurrence rates at the first and third month after treatment in the observation group were 2.70%(1/37) and 8.11%(2/37), respectively, which were significantly lower than those in the control group [16.22%(6/37) and 27.03%(10/37)] (χ 2=3.945, 4.573, all P<0.05). The satisfaction rate of patients in the observation group was 94.59%(35/37), which was significantly higher than 78.38%(29/37) in the control group(χ 2=4.163, P<0.05). Conclusion:On the basis of conventional drug treatment, CO 2 laser microinvasive surgery can effectively improve the treatment effect, improve the voice function of patients, and significantly reduce the recurrence rate, the overall effect and prognosis are better.

Objective To investigate the efficacy of ultrasound-guided transveses abdominis plane block ( TAP) on anesthesia and postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods From January 2015 to July 2017,60 patients aged 46 -68 yeas,of American Society of Anesthesiologists (ASA) physical status I-II,scheduled for elective gynecological laparoscopic surgery in Nanxiang Hospital of Jiading District of Shanghai were randomly divided into control group( A group) and ultrasound-guided TAP group( B group) ,with 30 cases in each group,In B group,ultrasound-guided TAP was performed 30 min before induction of anesthesia. The patients in both two groups received patient-controlled intravenous analgesia ( PCIA) for 48 h started from 10 min before the end of surgery. The VAS score ≥4points,sufentanil 5μg was injected intravenously. The consumption of anesthesia drugs during operation,time of consciousness and extubation,the consumption of sufentanil per hour in 24h after operation,requirement for rescue medication,and the adverse reactions within 24h after surgery were also recor-ded. Results Compared with those in A group,the consumption of propofol[(210 ± 32) mg vs. (324 ± 45) mg], sufentanil[(31 ± 3. 6)μg vs. (42 ± 3. 8)μg] in operation and consumption of sufentanil per hour in 24h after operation [(3.2±0.5)μgvs.(5.4±0.7)μg?inBgroupweresignificantlylower(P<0.001).Thetimeofconsciousness [(12 ± 3)min vs. (20 ± 5)min]and extubation[(15 ± 4)min vs. (25 ± 7)min]were significantly reduced in B group (P<0. 001). The requirement for rescue medication(13％ vs. 40％) and the incidence rate of nausea(10％ vs. 33％) and vomiting(0％ vs. 10％) within 24h after surgery were significantly decreased in B group compared with those in A group (P<0. 05). Conclusion Ultrasound-guided TAP performed in patients undergoing gynecologicallaparoscopic surgery can reduce the consumption of anesthesia drugs in operation and optimize postoperative analgesia.

Objective: To establish experimental porcine model of reconstruction the neobladder by ileal seromuscular with transplantation of autologous peritoneum. Methods: This was an animal experiment carried out from January to April 2018 at animal center of Guizhou Medical University. Randomly 6 experimental female porcines were chosen, and their body weight was 28 to 33 kg. By intravenous anesthesia, the transplantation of autologous peritoneum for bladder reconstruction operation was carried out by transplanting the peritoneum onto an ileum segment which mucosa and submucosa had been removed. These flaps were used to mend and reconstruct the neobladder by suturing with edge of the detective bladder. After removal of ureteral catheters and balloon catheter at day 5 and day 7 respectively, voiding behavior was monitored, and animals were euthanized at week 12 for routine pathology, immunohistochemistry, and electron microscopic examinations. Results: Six porcines underwent reconstruction, but no one lost to complications such as peritonitis, ileus and urinary fistula. Voiding behavior was normal, and urine was clear in all animals after removal of catheters. At autopsy, reconstructed bladders were healthy. Pathological examination showed the part of reconstruction had been covered by continuous urothelium while the peritoneum disappeared and showed no ileal mucosa regrowth and residual. Scanning electron microscope showed that the transitional cells of neobladder were complete and orderly, and urothelium around suture border was continuous and no malposition. Conclusion In this experimental porcine model, reconstruction bladder by autologous peritoneum and ileal seromuscular flaps is an ideal approach.

Objective To establish experimental porcine model of reconstruction the neobladder by ileal seromuscular with transplantation of autologous peritoneum. Methods This was an animal experiment carried out from January to April 2018 at animal center of Guizhou Medical University. Randomly 6 experimental female porcines were chosen, and their body weight was 28 to 33 kg. By intravenous anesthesia, the transplantation of autologous peritoneum for bladder reconstruction operation was carried out by transplanting the peritoneum onto an ileum segment which mucosa and submucosa had been removed. These flaps were used to mend and reconstruct the neobladder by suturing with edge of the detective bladder. After removal of ureteral catheters and balloon catheter at day 5 and day 7 respectively, voiding behavior was monitored, and animals were euthanized at week 12 for routine pathology, immunohistochemistry, and electron microscopic examinations. Results Six porcines underwent reconstruction, but no one lost to complications such as peritonitis, ileus and urinary fistula. Voiding behavior was normal, and urine was clear in all animals after removal of catheters. At autopsy, reconstructed bladders were healthy. Pathological examination showed the part of reconstruction had been covered by continuous urothelium while the peritoneum disappeared and showed no ileal mucosa regrowth and residual. Scanning electron microscope showed that the transitional cells of neobladder were complete and orderly, and urothelium around suture border was continuous and no malposition. Conclusion In this experimental porcine model, reconstruction bladder by autologous peritoneum and ileal seromuscular flaps is an ideal approach.