OBJECTIVE To study the interventional effect and mechanism of 1，8-cineole on pancreatic β cell ferroptosis induced by type 2 diabetes. METHODS In vitro ferroptosis model was established in pancreatic β cells of mice by using high glucose. The effects of low-dose and high-dose 1，8-cineole （0.25， 0.5 μmol/L） on the level of Fe2+ in pancreatic β cells were investigated. The effects of 1，8-cineole （0.5 μmol/L） combined with ferroptosis inducer Erastin （20 μmol/L） and ferroptosis inhibitor Ferrostatin-1 （20 μmol/L） on the protein expressions of glutathione peroxidase-4 （GPX4） and cyclooxygenase-2 （COX2） were also detected. The type 2 diabetes model mice were established by feeding high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin. The effects of low-dose and high-dose 1，8-cineole （50， 200 mg/kg） on the pathological morphology of pancreatic tissue， the content of iron as well as the protein expressions of GPX4 and COX2 were investigated. RESULTS The results of the cell experiment showed that compared with the model group， pretreatment with 1，8-cineole significantly reduced intracellular Fe2+ levels and upregulated GPX4 protein expression， while downregulated COX2 protein expression in pancreatic β cells （P＜0.05）. After combining with Ferrostatin-1， the expression trends of the above two proteins were the same， while there was no statistically significant difference after combining with Erastin. The results of animal experiments showed that compared with the model group， after intervention with 1，8-cineole， the structure of the pancreatic islets in mice recovered intact and their morphology improved； the iron content of pancreatic tissue and protein expression of COX2 were decreased significantly （P＜0.05）， while protein expression of GPX4 was increased significantly （P＜0.05）. CONCLUSIONS 1，8-cineole could ameliorate pancreatic β cell injury induced by diabetes， the mechanism of which may be related to reducing intracellular iron deposition and regulating ferroptosis-related proteins.

Objective To investigate the status of occult hepatitis B virus infection(OBI)among blood donors in Quzhou,Zhejiang,and to analyze the mutation of S region in blood donors with anti-HBc+alone and non anti-HBc+alone.Methods The OBI samples were screened by ELISA and NAT;the HBV DNA was amplified and sequenced;20 anti-HBc+alone and 25 not anti-HBc+alone samples were obtained.Results The detection rate of OBI in Quzhou was 0.10%(155/161 045),and the positive rate of anti-HBc was 74.19%(115/155).The detection rate of OBI increased with the age of blood donors(P＜0.05),but was not related to gender.The positive rate of anti-HBc+alone was 22.58%(35/155),and that of not anti-HBc alone was 51.61%(80/155).Among the 45 OBI sequencing samples,the proportion of B and C geno-type was73.33%(33/45)and 20.00%(9/45),respectively.The mutation sites of blood donors in the anti-HBc+alone group were more than those in the not anti-HBc+alone group,and the mutation rates of S114T and V168A on MHR were significantly different(P＜0.05).Conclusion The genotype of OBI infection in Quzhou is mainly type B.The mutation sites of blood donors with anti-HBc+alone are higher than those with not anti-HBc+alone,which may be more suitable as one of the OBI screening indicators.

Acute pancreatitis (AP) is a severe disease with an increasing incidence rate in clinical practice. Although most patients have mild pancreatitis, the fatality rate of severe pancreatitis remains at a relatively high level, and therefore, early-stage, simple, and accurate clinical scoring systems are urgently needed to determine the severity of AP, so as to facilitate effective disease management and symptomatic treatment and reduce the fatality rate of patients. At present, a large number of studies have demonstrated that the scoring systems such as Ranson score, APACHE Ⅱ score, BISAP score, CTSI score, and some serological markers have been used to evaluate the severity and prognosis of AP, but all of them have certain limitations. This article reviews the research advances in the existing scoring systems, single serological markers, and related modified scoring systems in recent years. Through a literature review, it is concluded that there is no a single scoring system or a single indicator that can cover the whole process of AP diagnosis and treatment and accurately judge the severity of AP, and therefore, it is necessary to develop a new scoring system or combine various indicators for comprehensive evaluation.

OBJECTIVE：To provid e reference for the medicinal resources and clinical application of Tibetan medicine “Dida”. METHODS：Delphi method was adopted. By reviewing literatures ，confirming consultation scope ，inviting experts engaged in clinical，scientific research ，teaching and production of Tibetan medicine. Two methods ，online inquiry and on-site questionnaire ， were used for expert consultation to evaluate the differences and problems existing in the utilization of “Dida”medicinal resources until a consensus was reached ，consensus on the medicinal resources and clinical application of Tibetan medicine “Dida”was determined finally. RESULTS & CONCLUSIONS ：A total of 33 experts participated in the two rounds of consultation. According to the results of literature research ，the first round set up 16 inquiry indicators ；and then according to expert opinions to modify the index system ，the second round set up 18 inquiry indicators. After two rounds of inquiry ，a consensus was finally reached on 16 items on the original name ，quality standards and clinical application of Tibetan medicine “Dida”，and 2 items related to the characteristics and compatibilities of “Dida”had not reach common views. The consensuses of 16 items mainly cover the original name of “Dida”and the evolution of geographic information ，the rational selection of “Dida”medicinal materials ，the effectiveness and safety of clinical use of “Dida”.

Objective:This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods:In 2015, an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province. A total of 28 000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method. All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire (GHQ). The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual, Forth edition (DSM-Ⅳ) axis I or MMSE. All participants at high risk of mental disorders were evaluated using DSM-Ⅳ or MMSE to confirm the psychiatric diagnoses, while 10% of participants at low risk of mental disorders were randomly selected to be evaluated. The prevalence and its 95% confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample. The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results:A total of 27 489 individuals completed survey. The adjusted prevalence of any mental disorder was 17.46% (95 %CI 17.02%-17.89%). The five most prevalent mental disorder spectrums were substance use disorders (5.29%), mood disorders (4.47%), anxiety disorders (4.46%), intellectual and mental disorders due to physical or substance (1.91%), and psychotic disorders (1.12%). The most common mental disorders were alcohol use disorder (5.27%) and major depressive disorder (2.14%). The prevalence of mental disorders in men was higher than that in women (23.37% vs. 13.89%; χ 2=408.91, P<0.01). There was no significant difference in the prevalence of mental disorders between rural residents and urban residents (17.69% vs. 17.20%; χ2=1.05, P=0.305). Of participants with mental disorders, 26.12% (1 047/4 008) had moderate to severe functional impairment and 10.98% (428/3 898) have sought professional help. Conclusion:The prevalence of mental disorders among people aged 18 and above in Shandong Province is basically consistent with the results of similar domestic studies. The prevalence of mental disorder was higher in men than in women and was not differ in participants living in urban and rural areas. Alcohol use disorder, major depressive disorder, non-specific anxiety disorder and non-specific depressive disorder are most common mental disorders.

Objective:This study aims to investigate the prevalence and distribution characteristics of mental disorders among people aged 18 and above in Shandong Province.Methods:In 2015, an epidemiological survey was carried out to investigate the patterns of mental disorders in 49 counties of Shandong Province. A total of 28 000 individuals aged 18 years or older were selected using the multistage stratified cluster sampling method. All these participants were classified as at a high or low risk of mental disorders according to the assessment results of the revised version of the General Health Questionnaire (GHQ). The diagnosis of mental disorders was confirmed using the Structured Clinical Interview for Diagnostic and Statistical Manual, Forth edition (DSM-Ⅳ) axis I or MMSE. All participants at high risk of mental disorders were evaluated using DSM-Ⅳ or MMSE to confirm the psychiatric diagnoses, while 10% of participants at low risk of mental disorders were randomly selected to be evaluated. The prevalence and its 95% confidence interval of mental disorders were adjusted according to study design and sociodemographic characteristics of the sample. The between-group differences of prevalence were compared using chi-square tests or Fisher′s exact tests as appropriately.Results:A total of 27 489 individuals completed survey. The adjusted prevalence of any mental disorder was 17.46% (95 %CI 17.02%-17.89%). The five most prevalent mental disorder spectrums were substance use disorders (5.29%), mood disorders (4.47%), anxiety disorders (4.46%), intellectual and mental disorders due to physical or substance (1.91%), and psychotic disorders (1.12%). The most common mental disorders were alcohol use disorder (5.27%) and major depressive disorder (2.14%). The prevalence of mental disorders in men was higher than that in women (23.37% vs. 13.89%; χ 2=408.91, P<0.01). There was no significant difference in the prevalence of mental disorders between rural residents and urban residents (17.69% vs. 17.20%; χ2=1.05, P=0.305). Of participants with mental disorders, 26.12% (1 047/4 008) had moderate to severe functional impairment and 10.98% (428/3 898) have sought professional help. Conclusion:The prevalence of mental disorders among people aged 18 and above in Shandong Province is basically consistent with the results of similar domestic studies. The prevalence of mental disorder was higher in men than in women and was not differ in participants living in urban and rural areas. Alcohol use disorder, major depressive disorder, non-specific anxiety disorder and non-specific depressive disorder are most common mental disorders.

Objective: To analyze the epidemiological and etiological characteristics of aggregation epidemics of infectious diarrhea induced by norovirus, and to provide the scientific basis for the prevention and control. Methods: A descriptive epidemiological analysis of aggregation epidemics events occurred during 2016-2018 in Longhua District of Shenzhen was carried out, with subtypes identified by real-time fluorescence quantitative PCR, Region B and Region C fragment sequence determination. Results: There were 34 aggregation epidemic events,including 448 cases, the mean attack rate was 18.26%(448/2 454). The median duration of aggregation epidemic was 3 days. The peak season appeared in autumn and winter, and the peak of epidemic emerged from December 2016 to April 2017. About 91.18% (31/34) of the epidemics occurred in schools and child care centers, and among children aged 3-6 years (78.79%, 353/448). The clinical symptoms were mainly nausea and vomiting (95.77%, 408/426) in children and adolescents but diarrhea in adult group (95.45%, 21/22). The differences between vomiting and diarrhea were both statistically significant in the two age groups (χ2=98.89，99.61，P<0.01). 29 cases were transmitted through interpersonal network, of which 21 cases were found to have unregulated treatment of vomit on campus. The detection rate of biological samples was 49.15% (203/413), all of which were G Ⅱ norovirus. The genotype was mainly GⅡ.P16-G Ⅱ.2(n=49)from November 2016 to April 2017. Conclusion Norovirus can cause large-scale outbreaks in child care centers and schools easily. Early standardized patient isolation and proper management of vomit and diarrhea are the key steps in prevention and control measures.

Objective:To explore efficacy and safety of endovascular therapy combined with hyperbaric oxygen (HBO) intervention in acute anterior circulation macrovascular occlusion stroke.Methods:A total of 150 patients with acute anterior circulation macrovascular occlusive stroke admitted in No.902 Hospital of the CPLA Joint Logistic Support Force were selected and randomly divided into endovascular treatment group and combined treatment group (endovascular+ HBO). Endovascular therapy was adopted in the treatment of all patients. Modified thrombolytic flow grading (mTICI) was used to evaluate vascular recanalization after operation, and the incidences of complications of hemorrhage transformation and vascular re-occlusion were recorded. National institutes of health stroke scale (NIHSS) was used to evaluate the neurological functions on admission, at 24 hours after the operation, and one course after HBO therapy. The prognosis was evaluated by observing the changes of blood homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment. The patients had been followed up by the modified Rankin Scale (mRS) for 90 days. At the same time, 75 patients with acute anterior circulation macrovascular occlusive stroke without taking endovascular treatment were selected as the control group.Results:Among 150 patients, 126 cases had a grade of mTICI≥2b, while 24 cases had a grade of mTICI<2b. Postoperative vascular re-occlusion occurred in 3 cases, and symptomatic intracranial hematoma occurred in 6 cases. The NIHSS score at 24 hours after the operation was significantly lower than that on admission, and the NIHSS score was further improved after HBO treatment. Ninety days after the operation, mRS showed 98 cases of good prognoses, while 52 cases of poor prognoses. The levels of HCY and hs-CRP were significantly lower than those before the treatment.Conclusion:Endovascular therapy for acute anterior circulation macrovascular occlusive stroke is safe and effective. Postoperative HBO therapy can significantly improve the prognosis and the quality of life of patients.

Objective:To explore efficacy and safety of endovascular therapy combined with hyperbaric oxygen (HBO) intervention in acute anterior circulation macrovascular occlusion stroke.Methods:A total of 150 patients with acute anterior circulation macrovascular occlusive stroke admitted in No.902 Hospital of the CPLA Joint Logistic Support Force were selected and randomly divided into endovascular treatment group and combined treatment group (endovascular+ HBO). Endovascular therapy was adopted in the treatment of all patients. Modified thrombolytic flow grading (mTICI) was used to evaluate vascular recanalization after operation, and the incidences of complications of hemorrhage transformation and vascular re-occlusion were recorded. National institutes of health stroke scale (NIHSS) was used to evaluate the neurological functions on admission, at 24 hours after the operation, and one course after HBO therapy. The prognosis was evaluated by observing the changes of blood homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment. The patients had been followed up by the modified Rankin Scale (mRS) for 90 days. At the same time, 75 patients with acute anterior circulation macrovascular occlusive stroke without taking endovascular treatment were selected as the control group.Results:Among 150 patients, 126 cases had a grade of mTICI≥2b, while 24 cases had a grade of mTICI<2b. Postoperative vascular re-occlusion occurred in 3 cases, and symptomatic intracranial hematoma occurred in 6 cases. The NIHSS score at 24 hours after the operation was significantly lower than that on admission, and the NIHSS score was further improved after HBO treatment. Ninety days after the operation, mRS showed 98 cases of good prognoses, while 52 cases of poor prognoses. The levels of HCY and hs-CRP were significantly lower than those before the treatment.Conclusion:Endovascular therapy for acute anterior circulation macrovascular occlusive stroke is safe and effective. Postoperative HBO therapy can significantly improve the prognosis and the quality of life of patients.