Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Objective To study the current situation of chronic diseases among island residents who have drunken desalinated water for a long time， and to reveal the relationship between drinking desalinated water and water from other sources and the prevalence of chronic diseases among the population. Methods According to the different drinking water sources of island residents， the research subjects were divided into seawater desalination group （residents of Gouqi Township， Shengsi County）， mixed water source group （residents of Shengshan Town， Shengsi County） and freshwater group （residents of Huanglong Township， Shengsi County）. Through the chronic disease network report and resident health file system， the current situation of chronic diseases in different water groups was investigated and analyzed. Results There were significant differences in the prevalence of malignant tumor among drinking water sources （ χ ²=23.867， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of coronary heart disease （ χ ²=194.883， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of stroke （ χ ²=35.637， P <0.001）， with the prevalence of fresh water group > mixed water group > desalination group. There was no significant difference in the prevalence of diabetes mellitus （ χ ²=2.808， P =0.246）， but there was significant difference in the age of onset of diabetes mellitus （ χ ²=7.368， P =0.001）， and significant difference in the prevalence of diabetes mellitus in the age group ≥55 （ χ ²=17.144， P <0.001）， and the onset age and prevalence were all in the order of fresh water group > desalination group > mixed water source group. There was no significant difference in the prevalence of hypertension （ χ ²=3.962， P =0.138）， but there was significant difference in the prevalence of hypertension in the age group ≥55 （ χ ²=20.734， P <0.001）， with the prevalence of fresh water group > desalination group > mixed water source group. Conclusion Long-term consumption of desalinated water by residents is correlated with malignant tumors， coronary heart disease and stroke， and has no correlation with diabetes and hypertension.

Antibody-drug conjugates(ADCs)are commonly heterogeneous and require extensive assessment of exposure-efficacy and exposure-safety relationships in preclinical and clinical studies.In this study,we report the generation of a monoclonal antibody against monomethyl auristatin E(MMAE)and the development,validation,and application of sensitive and high-throughput enzyme-linked immunosor-bent assays(ELISA)to measure the concentrations of MMAE-conjugated ADCs and total antibodies(tAb,antibodies in ADC plus unconjugated antibodies)in cynomolgus monkey sera.These assays were suc-cessfully applied to in vitro plasma stability and pharmacokinetic(PK)studies of SMADC001,an MMAE-conjugated ADC against trophoblast cell surface antigen 2(TROP-2).The plasma stability of SMADC001 was better than that of similar ADCs coupled with PEG4-Val-Cit,Lys(m-dPEG24)-Cit,and Val-Cit linkers.The developed ELISA methods for the calibration standards of ADC and tAb revealed a correlation be-tween serum concentrations and the OD450 values,with R2 at 1.000,and the dynamic range was 0.3-35.0 ng/mL and 0.2-22.0 ng/mL,respectively;the intra-and inter-assay accuracy bias％ranged from-12.2％to-5.2％,precision ranged from-12.4％to-1.4％,and the relative standard deviation(RSD)was less than 6.6％and 8.7％,respectively.The total error was less than 20.4％.The development and validation steps of these two assays met the acceptance criteria for all addressed validation parameters,which suggested that these can be applied to quantify MMAE-conjugated ADCs,as well as in PK studies.Furthermore,these assays can be easily adopted for development of other similar immunoassays.

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

In view of the current teaching status of Traditional Rehabilitation Methodology for rehabilitation medicine specialty in higher medical colleges and universities,combining with the knowledge of some acupoints taught in this course,we put forward some suggestions for the teaching of this course.In teaching process of acupoints knowledge,while emphasizing the importance of its anatomical location,we should also attach importance to elaborating the name of acupoints and the rich cultural contents contained in the naming process.At the same time,paying attention to induction learning and finding memory rules,combining theoretical knowledge with classmates' hands-on practice,and encouraging students to participate early in clinical practice activities,we can develop students' practical work ability.

Objective To investigate cognitive functions in first-episode schizophrenia and unaffected first-degree relatives of different patients.Methods A total of 52 patients with first-episode schizophrenia (patient group),48 unaffected first-degree relatives of different patients (relatives group) and 50 healthy normal controls (control group) was recruited in the study.The attention,memory,and executive functions of all the subjects were assessed by a battery of neuropsychological tests,including cancellation test (CT),trail making test (TMT),digit span (DS),visual reproduction (VR),verbal fluency task (VFK),Wisconsin card sorting test (WCST) and HANOI tower.Results There were statistically significant difference among three groups in net scores of CT,TMTA,TMT-B,backward and total scores of DS,scores of VR,VFK,total errors and perseverate errors of WCST and all indicators of HANOI Tower (P ＜0.05 or P ＜ 0.01).Post Hoc multiple comparisons showed that,compared with the control group,the patient group had worse scores in all tests above except TMT-A in the relatives group (P ＜0.05 orP ＜0.01).However,compared with the patient group,the relatives group had better scores in net scores of CT,TMT-A,TMT-B,scores of VR,VFK,total errors and perseverate errors of WCST (P ＜ 0.05 or P ＜ 0.01).Conclusions Patients with first-episode schizophrenia have global cognitive functions deficits.Unaffected first-degree relatives of different patients also have cognitive deficits to a certain extent.Our study indicates that cognitive functions deficits may be viewed as a biomarker for candidates reflecting genetic liability for schizophrenia.

Objective To determine the relationship between characteristic damages in white matter and its executive dysfunction by magnetic resonance diffusion tensor imaging (DTI) in the patients with leukoaraiosis (LA). Methods A total of 23 patients with LA and 19 age,sex and education-matched healthy people as control were enrolled.Montreal cognitive assessment (MoCA),Stroop test,trail making test (TMT),digit-symbol test(DST),verbal fluence (VF) were applied to assess cognitive and executive functions.Fractional anisotropy (FA),apparent diffusion coefficient (ADC) and mean diffusivity (MD) in white matter lesion (WML) and normal appearing white matter (NAWM) were measured in LA group,the bilateral centrum semiovale,anterior and posterior periventricular white matter in control group were measured by DTI. The white matter DTI parameters were compared between the groups, the relationship between DTI parameters and executive function was investigated in LA group. Results In LA patients,distinct executive dysfunction were found.The scores of Stroop B [(69.4± 13.4) vs.(43.3 ± 5.0),t =8.03,P＜0.05)],Stroop C [(141.4±42.1) vs.(65.4±10.3),t=7.66,P＜0.05)]and Stroop C B[ (72.0±41.4) vs.(22.1±9.6),t=5.13,P＜0.05)],TMT-A[(73.2±15.3)vs.(31.2±7.2),t 10.97,P＜0.05) ],TMTB[(125.6±18.0) vs.(81.6±5.9),t=10.22,P＜0.05) ] andDST[ (24.8±5.6 )vs.(36.8±5.1),t=7.19,P＜0.05) ] were inferior in LA group to control group.The values of FA in centrum semiovale [(0.2±0.1) vs.(0.4±0.1) and (0.4±0.1),F =45.08,P＜0.05)],anterior periventricular white matter [(0.2±0.0) vs.(0.4±0.1) and (0.4±0.1),F =70.11,P＜0.05)] and posterior perivcntricular white matter[ (0.3±0.1) vs.(0.4±0.1) and (0.4±0.1),F=8.54,P＜0.05) ]of WML were reduced as compared with those of NAWM and control group.The values of ADC(×10- 3mm2/s) in the above three regions of WML [(1.2±0.2) vs.(0.8±0.1) and (0.8±0.1),F=46.77,P＜0.05)],[(1.2±0.3) vs.(0.8±0.0) and (0.8±0.1),F=68.22,P＜0.05)]and [(1.4±0.3) vs.(0.8±0.0) and (0.9±0.1),F=17.08,P＜0.05) ] were elevated,as compared with those of NAWM and control group,and the values of MD ( × 10-5 mm2/s) in the three regions of WML[ (127.8±14.5) vs. (95.3±26.4) and (100.8±9.4),F 19.72,P＜0.05) ],[(127.4±16.0) vs.(101.8±13.9) and (93.4±5.6),F=39.26,P＜0.05) ] and [(134.4±21.2)vs.(114.8=14.5) and (114.4±11.7),F=10.66,P＜0.05) ]were also increased,as compared with those of NAWM and control group.There was negative correlation of FA with Stroop C-B (r=-0.46,P＜0.05),TMT-A (r=-0.48,P＜0.05) and TMT-B (r=0.46,P＜0.05),while FA was positively related with DST test (r=0.42,P＜0.05) in anterior periventricular white matter.Conclusions DTI can detect the characteristic damages of white matter,which is strongly related with executive function impairments possibly induced by the damage of prefrontal-subcortical loop in the patients with LA.

The experiment was conducted to examine the effect of zinc toxicity on the peripheral blood T-lymphocyte by the method of flow cytometry(FCM) and ANAE.200 one-day-old Avian broilers were divided into four groups,and fed with the diets as follows:①control group(Zn 100 mg/kg diet) and ② zinc toxic groups(Zn 1 500 mg/kg diet,zinc toxic group Ⅰ;Zn 2 000 mg/kg diet,zinc toxic group Ⅱ;Zn 2 500 mg/kg diet,zinc toxic group Ⅲ) for seven weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the three zinc toxic groups than that in control group at 7 weeks of age.CD4+ T cell numbers were reduced from 2 to 7 weekds of age in zinc toxic group Ⅲ and from 6 to 7 weeks of age in zinc toxic group Ⅱ,as compared with that of control group.The numbers of CD8+ T cell decreased at 2 and 4 weeks of age in zinc toxic groups Ⅱ and Ⅲ,and at 7 weeks of age in zinc grups Ⅰ and Ⅲ.CD4+/CD8+ ratio was higher at 2 and 4 weeks age,and lower at 6 and 7 weeks of age in zinc toxic groups Ⅰ,Ⅱ and Ⅲ than in control group.The results showed that zinc toxicity would suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanism underlying these observations are also discussed.

The experiment was conducted to examine the effect of copper toxicity on the peripheral blood T-lymphocyte using the flow cytometry(FCM) and ANAE.180 one-day-old Avian broilers were divided randomly into three groups,and fed diets as follows:(1)Controls(Cu 11.97 mg/kg diet) and (2)copper toxic(Cu 650 mg/kg diet,copper toxic group Ⅰ;Cu 850 mg/kg diet,copper toxic group Ⅱ) for six weeks.The ANAE positive ratios of the peripheral blood T-lymphocytes were much lower in the two copper toxic groups than in control group from 1 to 6 weeks of age(P＜0.05 or P＜0.01).Also,there was significant difference between copper toxic groups Ⅰ and Ⅱ at 1,3,5 and 6 weeks of age(P＜0.05 or P＜0.01).CD+4 T cell numbers reduced from 2 to 6 weeks of age in both copper toxic group Ⅰ and copper toxic group Ⅱ as compared with those of control group(P＜0.05 or P＜0.01).At the same time,there was significant difference between copper toxic groups Ⅰ and Ⅱ at 6 weeks of age(P＜0.05).But the numbers of CD+8 T cell were not varied from 2 to 6 weeks of age in copper toxic groups Ⅰ and Ⅱ in comparison with those of control group(P＞0.05).The CD+4/CD+8 ratio was lower from 2 to 6 weeks of age in copper toxic groups Ⅰ and Ⅱ than in control group.The results showed that copper toxicity could suppress the development of T-lymphocytes and reduce the peripheral blood T-lymphocyte populations.Potential mechanisms underlying these observations are also discussed.