OBJECTIVE To establish a rapid analytical method to identify the chemical components in Xitong preparations for the treatment of rheumatoid arthritis by ultra-high performance liquid chromatography coupled triple time-of-flight mass spectrometry(UPLC-Triple-TOF-MS/MS). METHODS The analysis was performed on an ACQUITY UPLC HSS T3 (2.1 mm×150 mm, 1.8 μm) column with the mobile phase consisting of water containing 0.1% formic acid(A) and acetonitrile containing 0.1% formic acid(B) in gradient mode at a flow rate of 0.3 mL·min−1. Data acquisition was carried out under positive and negative ion modes. The processed data was analyzed by Peakview software and compound database. The chemical components were determined by comparison with standard products, combining with the characteristic fragments in secondary MS, and those in the related literatures. RESULTS Seventy-eight compounds were identified including 20 phenylpropanoids, 33 terpenes, 19 flavonoids, 6 oxylipins, two of which might be new compounds. CONCLUSION The method can be used for rapid identification of chemical compositions in Xitong preparations, which provides basis for quality control and elucidation of phamarcodynamic material basis of Xitong pills and capsules .

Objective To investigate the effect of embryonic inflammatory exposure on the response of mouse offspring to interphotoreceptor retinoid-binding protein(IRBP)-induced experimental autoimmune uveitis(EAU).Methods RNA transcriptome sequencing data from eyeballs of C57BL/6J mouse offspring born to mothers with active EAU were used to screen immune-associated differentially expressed genes in the eyes of the exposed offspring.Gene fragments overlapping in the two datasets were screened using Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses to identify biological pathways associated with the gene fragments.Hub genes were identified from these intersecting genes by protein-protein interaction network analysis.EAU models of maternal uveitis were established by immunization with IRBP651-670,and expression levels of the pivotal genes in the offspring exposed to inflammation by maternal uveitis were examined by fluorescence quantitative polymerase chain reaction.EAU severity,T lymphocyte proliferation,and serum cytokines were detected to investigate the immune effect in offspring from mothers with an active inflammation response to IRBP induction.Results Microarray analysis identified 72 immune-related differentially expressed genes in exposed samples compared with the findings in control samples.These genes were mainly enriched in Toll-like receptor signaling,mitogen-activated protein kinase signaling,and B cell receptor signaling pathways.Protein-protein interaction network interaction analysis screened out four hub genes,Psmc5,Psmc3,Psmd4,and Psmd8,and mRNA levels of these four genes were increased in the adult offspring from mothers with active uveitis compared with the findings in healthy offspring.In addition,the group induced with 150 μg IRBP showed an increase in the severity of clinical and pathological outcomes in offspring with EAU affected by active inflammation,compared with the healthy offspring group(P=0.0087,P=0.0410).Meanwhile,T cell proliferation in the offspring was enhanced during the inflammatory activity stage and secretion of the inflammatory cytokines interleukin(IL)-17 and IL-6 was increased(P=0.0450,P=0.0300).Conclusions Psmc5,Psmc3,Psmd4,and Psmd8 may be important genes exacerbating uveitis in offspring of mothers with active uveitis,associated with increased T cell proliferation and production of IL-17 and IL-6.

Objective:To explore the association between different feeding patterns, emotional states, and salivary oxytocin (OT) levels during breastfeeding.Methods:From January to December 2019, 153 pairs of 3-month-old infants and their mothers were recruited from 4 maternal and child health hospitals in Chongqing, Liuzhou, Dalian and Hangzhou in China.Saliva samples were collected from the mothers at the first 5 minutes of feeding, 5 minutes during feeding, and 10 minutes after feeding.Edinburgh postnatal depression scale (EPDS) was used to evaluate maternal depression.Infants were divided into exclusive breastfeeding group and artificial feeding group according to feeding patterns.ELISA of salivary oxytocin was performed by ELISA kits, and the OT levels measured at the 3 time points were converted using linear interpolation.Area under the curve with respect to ground(OTAUCG) was used to represent the total concentration of salivary OT during the mother's breastfeeding.SPSS 25.0 software was used for statistical analysis.Multiple linear regression analysis and two factors analysis of variance were used to explore the association between different feeding methods, emotional state and salivary oxytocin during breastfeeding.Results:The results of the two factors analysis of variance showed that the interaction between feeding pattern and mother's emotion was not significant ( F=2.440, P=0.120), the main effect of mother's emotion was not significant ( F=0.380, P=0.539), and the main effect of feeding style was significant ( F=3.350, P=0.021). The level of OTAUCG under pure breastfeeding ((151 561.47±75 738.11) pg/mL) was higher than that under artificial feeding ((122 269.03±65 029.88) pg/mL), and the difference was statistically significant ( P=0.02). There was no statistically significant difference in OTAUCG levels between mothers with normal emotions ((146 106.37±75 106.76) pg/mL) and mothers with depressed emotions ((129 079.56±67 565.87) pg/mL) ( P=0.221). Multiple stepwise regression analysis showed that artificial feeding had a negative predictive effect on maternal salivary OT levels compared to exclusive breastfeeding( β=-0.211, t=-2.513, P=0.013). Conclusion:Feeding pattern is a factor that affects the mother's salivary OT level, and breastfeeding can improve the mother's OT level.

Objective:Analyze the correlation between serum immunoglobulin G (IgG) N-glycan and Lauren classification of gastric cancer.Methods:A retrospective study was performed on 17 patients with diffuse type gastric cancer and 21 patients with intestinal type who received treatment in Zhongshan Hospital from 2017 to 2018, and the general medical history data and disease characteristics were summarized. The serum IgG glycome profiles were analyzed by ultraperformance liquid chromatography, and the difference between intestinal type and diffuse type gastric cance was compared.Logistic regression was used to evaluate the correlation between serum IgG N-glycan and Lauren classification.Results:IgG N-glycome analysis included 27 directly detected glycans and 4 derived traits. H=Hexose, N=N-acetylglucosamine, F=Fucose, S=Sialic acid.There was no significant difference in IgG N-glycan among different chemotherapy protocol. Compared with intestinal type, H3N3F1 ( t=3.785, P=0.001), H3N4( t=3.919, P=0.002), H3N4F1( t=2.770, P=0.005), H3N5F1( t=2.888, P=0.010) were decreased in diffuse type; H4N4F1(6)( t=?3.488, P<0.001), H5N4F1( t=?3.401, P=0.003), H5N5F1( t=?2.303, P=0.023), H5N4F1S1 ( t=?3.068, P=0.008) were increased.H3N3F1( OR:1.20, P=0.008), H3N4( OR:1.32, P=0.005), H3N4F1 ( OR:1.13, P=0.017), H3N5F1 ( OR:1.78, P=0.015), H4N4F1(6)( OR:0.43, P=0.008), H5N4F1(6)( OR:0.74, P=0.008), H5N5F1 ( OR:0.32, P=0.036), H5N4F1S1( OR:0.48, P=0.009) were significantly correlated with Lauren classification. Sialylated ( t=?2.717, P=0.012) and galactosylated ( t=?3.400, P=0.001) IgG N-glycan were reduced in patients with intestinal type gastric cancer.Galactosylated ( OR:0.87, P=0.007) and sialylated ( OR:0.62, P=0.015) IgG N-glycan were significantly correlated with Lauren classification. Conclusion:Some IgG N-glycan are significantly correlated with Lauren classification, which can be used as potential biomarkers.

Objective:To explore the evaluation value of abnormal muscle response (AMR) monitoring in efficacy of microvascular decompression in primary hemifacial spasm.Methods:A retrospective study was performed. Sixty-four patients with primary hemifacial spasm, admitted to our hospital from April 2019 to December 2020, were chosen. All patients underwent intraoperative AMR monitoring and were divided into AMR complete-disappeared group, AMR significant-changed group and AMR not significant-changed group according to the monitoring results. The relief of spasticity symptoms among the three groups was observed one week and one year after surgery. The specificity and sensitivity of AMR monitoring in evaluating the efficacy, the relations between intraoperative AMR changes and postoperative efficacy after microvascular decompression were analyzed.Results:The specificity and sensitivity of AMR monitoring in predicting spasmodic relief after microvascular decompression were 89.7% and 66.7%, respectively, at one week, and 86.7% and 50.0%, respectively, at one year. There were statistical differences in clinical remission rate one week after microvascular decompression among AMR complete-disappeared group ( n=46), AMR significant-changed group ( n=8) and AMR not significant-changed group ( n=10, P<0.05); there were no significant differences in clinical remission rate one year after microvascular decompression among the three groups ( P>0.05). There was no significant difference in clinical remission rate one week and one year after microvascular decompression between patients having AMR complete disappearance before Teflon and patients having AMR complete disappearance after Teflon ( P>0.05). Conclusion:AMR monitoring has high specificity but modest sensitivity in predicting spasmodic relief after microvascular decompression; intraoperative AMR disappearance is associated with short-term efficacy, but it is not a reliable indicator for long-term efficacy; the time of disappearance of intraoperative AMR has no guiding significance in judging the efficacy of patients with primary hemifacial spasm.

Objective To investigate the normal reference values of abdominal aorta and its branches in Southwest China, so as to provide basis for clinical diagnosis and treatment of abdominal aortic aneurysm. Methods The length, diameter and angle of the abdominal aorta and its branches were measured in 20 cadavers. At the same time, 300 cases without obvious pathological changes in four urban populations were selected for abdominal CT angiography (CTA) to measure the length, diameter and angle of abdominal aorta and its branches. Results Display rate of abdominal aorta was 100%,the average length of abdominal aorta was (12.96±0.81) cm, the diameter of abdominal aorta was (1.93±0.28) cm, (1.55±0.23) cm, (1.61±0.19) cm in renal artery plane (Ⅰ), inferior mesenteric artery plane (Ⅱ) and lower edge plane of lumbar vertebrae (Ⅲ), and the average value on image was (2.17 ± 0.42) cm, (1.81 ± 0.40) cm, (1.99 ± 0.53) cm; Display rate of common iliac artery was 100%, the angle between left and right common iliac artery was (59.80± 4.66) ° and the diameter of the end was (1.16±0.33) cm and (1.12±0.11) cm; Display rate of celiac trunk on cadaver was 100%, the average length was (1.61±0.27) cm, the average diameter on cadaver was (0.78±0.71) cm, the image was (0.88± 0.31) cm; Display rate of renal artery was 100%, the average length of the left renal artery was (2.58 ± 0.50) cm, that of the right was (4.26±0.65) cm, the initial average diameter of the left renal artery was (0.55±0.24) cm, and the right renal artery was (0.62±0.20) cm; Display rate of the superior mesenteric artery was (100%), that of the on cadaver was (4.56 ± 0.29) cm, that of the image was (4.93 ± 0.84) cm, and that of the angle between the abdominal aorta was (38.05±5.99)°; Display rate of the inferior mesenteric artery was (100%),the average length of the inferior mesenteric artery was (6.57±0.79) cm on the cadaver, the image was (6.70±0.76) cm, and that of the angle between the abdominal aorta was (73.79 ± 9.62) ° and the initial diameter was (0.48 ± 0.29) cm. Conclusion The normal reference values of abdominal aorta and its visceral branches in Southwest China population were measured. CTA has a special advantage in showing the lesions of abdominal aorta and its branches in lumen, extraluminal and vascular wall, which can provide anatomical data of patients before operation.

Objective:To explore the feasibility and effectiveness of the construction of urban unmanned aerial vehicle (UAV) blood distribution system, and to provide a novel way for the distribution of emergency blood.Methods:The study was completed in Hangzhou from April 2019 to January 2021, and the main participants were from the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province Blood Center and Hangzhou Fast Ant Network Technology Co., Ltd. Firstly, an unmanned aircraft delivery system was built for urban emergency blood and a special blood storage box for drones were developed. The drone was used to deliver blood products from Zhejiang Province Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine, and the following indicators were obtained: (1) flight time of the drone blood delivery; (2) real-time temperature of blood products during transportation; (3) Baidu map software was used to measure the blood delivery time of road traffic, which was compared with the flight time of the drone.Results:The urban drone blood delivery system consists of intelligent logistics drones, cryogenic blood storage tanks, unmanned logistics hub stations, and cloud-based operation control platforms. The drone route distance from Zhejiang Provincial Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine was 2.36±0.06 km, and the ground distance was 5.8 km, with 27 flights from April 12, 2019 to January 29, 2021, and the drone flight time was, shorter than the road travel time for a round trip [(6.37±0.35) min vs. (17.00±1.94) min]. At different time points of the day, UAV blood delivery could save 15.98-4.28 min, with an average saving of 10.62±1.87 min. Conclusions:Urban UAV blood delivery systems have the advantages of being fast, unaffected by ground traffic conditions, and can ensure the safety of blood products during transportation, and are worthy of further exploration.

Objective To examine the expression of miR-210,miR-155 and miR-34a in the peripheral blood of patients with systemic lupus erythematosus (SLE) and to analyze their clinical significance.Methods One hundred and teenty-six SLE patients were divided into the stable group (n=35),mild active group (n=49),medium and severe active group (n =42) based on systemic lupus erythematosus disease activity index (SLEDAI) score.Meanwhile,40 subjects for healthy check-up were selected as controls.The clinical data of patients were collected.Complete blood count,liver and kidney function and immunological indexes were tested in patients and the lupus activity index was assessed.The expression level of miR-210,miR-155 and miR-34a were determined by real-time polymerase chain reaction.Furthermore,the correlation between their levels and clinical parameters such as erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),SLEDAI score,were analyzed.The expression levels of miR-210,miR-155 and miR-34a in each group were compared by one-way analysis of variance (ANOVA).Correlation analysis was performed by non parametric Spearman test.The difference was statistically significant if P＜0.05.The diagnostic value of SLE was evaluated by the subjects characteristic (ROC) curve.Results The levels of miR-210 and miR-155 were no significantly differencet between the stable group (0.017±0.012);(0.150±0.101) and the control group (0.015±0.010);(0.071±0.034),but they were increased in mild active group (0.502±0.166);(1.521±1.138),medium and severe active group(1.237±0.584),(13.589±9.827) (F=124.321,70.065,P＜0.05).The average expression level of miR-34a in the control group,the stable group,the mild active group and the moderate and severe active group were (0.005±0.003),(0.249±0.137),(2.981±1.762) and (9.625±5.873) respectively,and showed a trend of increase in turn (F=75.688,P＜0.05).The expression level of miR-210,miR-155 and miR-34a was not significantly different between the LN group and the non LN group (P＞0.05).The R values of miR-210,miR-155,miR-34a and each index were IgG (0.347;0.518;0.482);IgA (0.463;0.635;0.379);IgM (0.287;0.392;0.336),ESR(0.317;0.428;0.369),C3(0.243;0.429;0.381),C4(0.317;0.513;0.429),ANA titer (0.462;0.594;0.527),Anti-ds-DNA antibodies (0.391;0.586;0.483),SLEDAI scores (-0.412;-0.558;-0.493),and there were significant correlations (P＜0.05).In patients with SLE,there was no significant correlation between hormone therapy alone or hormone plus immunosuppressive therapy (P＞0.05).The sensitivity and specificity of miR-210,miR-155,miR-34a in combination for the diagnosis of SLE reached 75.7％ and 72.3％,respectively.Conclusion The levels of miR-210,miR-155 and miR-34a in combination may be used as bio-markers for the diagnosis of SLE.

Holmes-Adie syndrome (HAS) is a clinical syndrome mainly characterized by tonic pupil and disappearance of tendon reflex. It is mostly idiopathic and can also be seen in cerebral diseases, such as trauma, infection and tumors. However, it is rarely reported to be accompanied with myasthenia gravis (MG). We report a case of MG and HAS, whose clinical manifestations were fluctuation of limb weakness, breathing difficulties, right ptosis. Her pupils were unequal: the left pupil was 3 mm, the right pupil was 2 mm, direct and indirect light reflex was slow in left pupil, and right pupil was sensitive to light reflex. The left eye pupil shrank to 2 mm after dripped pilocarpine diluent for 10 minutes, while the right pupil was still 2 mm. Chest CT examination revealed thymoma. After treatment with thymectomy, glucocorticoid, immunoglobulins and tacrolimus, her symptoms of MG were improved, but the left pupil diameter and light reflex were not changed. Combined with the patient's symptoms, physical signs and examinations, this patient was diagnosed as MG accompanied with HAS.

Objective To evaluate the effectiveness of hospital environmental cleaning practice by fluorescence labeling method.Methods From January to February 2015,312 ward rooms in 7 hospitals were chosen,high touch object surface were labeled with fluorescence,after object surface being cleaned by cleaners,clearance rates of fluorescence labeling were calculated (as baseline survey data),training and on-site guidance for cleaners were performed(intervention measures),fluorescence labeling clearance effect before and after intervention was compared.Results A total of 110 ward rooms were performed baseline survey,the fluorescence labeling clearance rate of 2 856 touched clean surface was only 50.81％,the quantitative evaluation value was 45.70;after intervention,202 rooms were surveyed,fluorescence labeling clearance rate of 3 992 touched clean surface enhanced to 79.23 ％,the quantitative evaluation value was 76.30;there was significant difference in fluorescence labeling clearance rate between before and after intervention (x2 =612.14,P＜0.05).In the baseline survey,the clearance rates of fluorescence labeling on touched surface of medical instruments,hospital beds,and toilets were 46.07％,37.80％,and 25.20％ respectively;after intervention,the clearance rates were 80.59％,75.90％,and 51.70％,respectively.After intervention,fluorescence labeling clearance rates of beepers,toilet seat covers,toilet electrical switches,and chairs were low,the clearance rates of these touched surface in baseline survey were＜ 30％,after intervention were 47.03 ％-68.32％;the clearance rates of other high touch surface were all＞75 ％.Conclusion Fluorescence labeling method can directly reflect the operation quality of cleaners,and improve the cleanliness of ward environment,it is a simple,inexpensive and objective globally popular method for evaluating hospital environment cleanliness.