Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

Objective To explore the intervention mechanism of Changzhou Tongbian Formula on functional constipation(FC)combined with depression in rats.Methods A rat model of FC combined with depressive-like behaviors was established by using gastric gavage of berberine hydrochloride and chronic unpredictable mild stress.The model rats were randomly divided into blank group,model group,lactulose group,and Changzhou Tongbian Formula high-,medium-,and low-dose groups,and the intervention was carried out for five weeks.The fecal water content was calculated before and after intervention.The small intestinal propulsion rate was calculated after intervention.The depressive-like behavior levels of rats were evaluated by forced swimming test and sucrose preference test before and after intervention.The colonic mucosal morphology was observed by HE staining.The morphology and number of pyramidal cells in the hippocampal CA1 and DG regions were observed by Nissl staining.The relative protein expression levels of the transient receptor potential vanilloid 4(TRPV4)in colonic tissue,as well as brain-derived neurotrophic factor(BDNF),tyrosine kinase receptor B(TrkB),mitogen-activated protein kinase(MAPK),and cAMP-response element binding protein(CREB)in the hippocampus of rats in each group were detected by Western Blot method.Results Compared with the blank group,the fecal water content of rats in the model group was significantly reduced(P＜0.001),the small intestinal propulsion rate was significantly lower(P＜0.01),the sucrose preference index was significantly decreased(P＜0.001),the number of pyramidal cells in the CA1 and DG regions of the hippocampus was significantly reduced(P＜0.001),and the TRPV4 in the colon and the BDNF,TrkB,MAPK,and CREB protein contents in the hippocampus were all significantly decreased(all P＜0.001).Compared with the model group,the fecal water content of the Changzhou Tongbian Formula high-,midium-,low-dose groups and the lactulose group were significantly increased(P＜0.001,P＜0.01).The small intestinal propulsion rate of the Changzhou Tongbian Formula high-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.05).The sucrose preference indices of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.05).There was no abnormality in the colonic histology.The numbers of pyramidal cells in the CA1 and DG regions of the hippocampus of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.01,P＜0.001).The TRPV4 content in the colon of the Changzhou Tongbian Formula high-,midium-,low-dose groups and lactulose group were significantly increased(P＜0.001),and the BDNF,TrkB,MAPK,and CREB protein contents in the hippocampus were all significantly increased(P＜0.05,P＜0.01,P＜0.001).Conclusion After intervention,Changzhou Tongbian Formula can significantly improve the TRPV4 content in the colon of model rats with the comorbidity of FC with depression,increase the moisture content of feces,promote intestinal peristalsis and improve constipation.Meanwhile,TRPV4 can activate the BDNF/TrkB/MAPK pathway,trigger an increase in downstream CREB,improve neuroplasticity and thus alleviate some depressive-like behavior.

Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.

Oral and maxillofacial organoids (OMOs), tiny tissues and organs derived from stem cells cultured through 3-d cell culture models, can fully summarize the cell tissue structure, physiological functions and biological characteristics of the source tissues in the body. OMOs are applied in areas such as disease modelling, developmental and regenerative medicine, drug screening, personalized treatment, etc. Although the construction of organoids in various parts of the oral and maxillofacial (OM) region has achieved considerable success, the existing cocktail formulae (construction strategies) are not widely applicable for tissues of various sources due to factors including the heterogeneity of the source tissues and the dependence on laboratory technology. Most of their formulae are based on growth factor niches containing expensive recombinant proteins with their efficiency remaining to be improved. In view of this, the cocktail formulae of various parts of the OM organs are reviewed with further discussion of the application and prospects for those OMOs to find some affordable cocktail formula with strong operability and high repeatability for various maxillofacial organs. The results may help improve the efficiency of organoid construction in the laboratory and accelerate the pace of the clinical use of organoid technology.

Objective:To investigate the effect of intranasal oxytocin administration on empathy in male adolescents with conduct disorder.Methods:The male adolescents with conduct disorder in the Psychological Counseling Clinic of the Second Xiangya Hospital of Central South University from September 2015 to August 2016 were selected.And they were randomly assigned to oxytocin group ( n=46) and placebo group ( n=51) by random number table. Subjects in oxytocin group were given nasal spray of 24 IU oxytocin twice per day for two weeks, while those in placebo group were given nasal spray of 0.9% sodium chloride solution for two weeks. The empathy of patients was assessed with a pain-related empathy task and interpersonal reactivity index (IRI) before and after two weeks′ administration. SPSS 20.0 software was used for statistical analysis, and repeated measurement analysis of variance was used to compare the empathy ability of the two groups before and after intervention. Results:Repeated measurement analysis of variance showed that there were significant time×group interaction effects in the scores of painful expressions during the pain-related empathy task ( F=13.86, P<0.001), IRI ( F=5.59, P=0.020) and empathic concern subscale ( F=4.99, P=0.028). There was significant between-group effect in the score of perspective-taking subscale of IRI( F=4.22, P=0.043). Simple effect analysis revealed that after two weeks of intervention, the score of needle-pain expression in oxytocin group was significantly higher than that at baseline ( t=-2.08, P=0.040). And the score of needle-pain expression in oxytocin group was significantly higher than that in placebo group ( t=2.33, P=0.022). After two weeks of intervention, the total IRI score ( t=-2.58, P=0.011) and empathy factor score ( t=-3.15, P=0.002) of oxytocin group were both higher than those at baseline. After intervention, the total IRI score ( t=2.30, P=0.024) and perspective-taking factor score ( t=2.57, P=0.012) in oxytocin group were higher than those in placebo group, and the differences were statistically significant. Conclusions:Oxytocin may improve the cognitive and emotional empathy in male adolescents with conduct disorder.

Objective:To investigate the status of work performance among rural doctors in Shanxi province and the factors related to their performance.Methods:From July to September 2019, 528 rural doctors in Shanxi province were selected by multi-stage stratified cluster sampling for the survey. Their job competency, job performance, psychological capital and burnout were evaluated. The structural equation model was used to construct the job performance analysis based on post competency.Results:The total score of post competency of rural doctors in Shanxi province was (188.6±20.3), and the total score of job performance was (71.3±11.5), both of which were in the middle level. The structural equation model was well fitted [goodness-of-fit index (GFI)=0.958, normal fix index (NFI)=0.920, adjusted goodness-of-fit index (AGFI)=0.910, root mean square error of approximation (RMSEA)=0.076]. Post competency, psychological capital and job burnout had direct effects on job performance ( P<0.05), with influence coefficients of 0.64, 0.35 and -0.25, respectively. Job competency indirectly affected job performance through psychological capital and job burnout ( P<0.05). Conclusion:The study suggest that higher post competency would facilitate to improve the work performance of rural doctors.

Chloroquine (CQ) phosphate has been suggested to be clinically effective in the treatment of coronavirus disease 2019 (COVID-19). To develop a physiologically-based pharmacokinetic (PBPK) model for predicting tissue distribution of CQ and apply it to optimize dosage regimens, a PBPK model, with parameterization of drug distribution extrapolated from animal data, was developed to predict human tissue distribution of CQ. The physiological characteristics of time-dependent accumulation was mimicked through an active transport mechanism. Several dosing regimens were proposed based on PBPK simulation combined with known clinical exposure-response relationships. The model was also validated by clinical data from Chinese patients with COVID-19. The novel PBPK model allows in-depth description of the pharmacokinetics of CQ in several key organs (lung, heart, liver, and kidney), and was applied to design dosing strategies in patients with acute COVID-19 (Day 1: 750 mg BID, Days 2-5: 500 mg BID, CQ phosphate), patients with moderate COVID-19 (Day 1: 750 mg and 500 mg, Days 2-3: 500 mg BID, Days 4-5: 250 mg BID, CQ phosphate), and other vulnerable populations (.., renal and hepatic impairment and elderly patients, Days 1-5: 250 mg BID, CQ phosphate). A PBPK model of CQ was successfully developed to optimize dosage regimens for patients with COVID-19.

Objective:To explore the attitude and behavior of scientific research in professional postgraduates majoring in stomatology in Peking University, proposing suggestions to improve the quality of scientific research training.Methods:150 professional postgraduates of stomatology including the 8-year program stomatological students (the postgraduate stage) of Peking University School of Stomatology were involved in the survey, information including the types of and attitudes to scientific research, the evaluation of research environments, the understanding of the relationship with their mentors, and the expected working institutions after graduation was collected by questionnaires.Results:A total number of 131 valid questionnaires were collected, with an effective rate of 87.3%. In terms of the type of research work, 70 (53.4%) were engaged in basic research and 30 (22.9%) in clinical research. In terms of attitudes towards scientific research training, 69 (52.7%) respondents agreed that scientific research and clinical practice promoted each other. The Likert scores of scientific research interest, ability, and pressure were 3.13 ± 0.84, 3.04 ± 0.84, and 4.14±0.71. The evaluation of laboratory conditions (3.30±0.92), scientific research funding (3.54±1.06), scientific research atmosphere (3.89±0.85), and reward and punishment mechanisms (3.82±0.76) were positive. The evaluations of scientific research training courses (2.89±0.88) and scientific training time (2.79±0.94) were negative. The average score of the rapport level between postgraduates and their mentors was 4.29±0.77, and 111 respondents (84.7%) had a correct understanding of the guiding relationship. Sixty-six respondents (50.4%) expected to engage in clinical and scientific research in stomatological schools and 61 (46.6%) expected to engage in clinical work only, after graduation.Conclusions:The scientific research for graduate students of stomatology in Peking University is mainly basic research, and the research pressure is relatively high. It is recommended to choose research topics in combination with clinical practice, clarify the significance of scientific research, optimize the scientific research environment and facilities, strengthen the tailored guidance of mentors, and to fulfill the " holistic training (Three All-round Education)" in professional postgraduate training.

Objective To investigate the prevalence of dental fluorosis in children aged 8-12 in coalburning-borne endemic fluorosis areas in 23 counties in Guizhou Province,and to evaluate the effects of prevention and control measures.Methods In 2014,five towns were selected according to their location of the east,the south,the west,the north and the center of the 23 counties,one primary school in each town was chosen.All the students aged 8-12 in each school were selected,according to the Diagnosis of Dental Fluorosis (WS/T 208-2011),dental fluorosis was examined.At the same time,the detection rate of dental fluorosis of children aged 8-12 was investigated in 23 counties in 2000 and 2007.Analysis and comparison of the data in 2000,2007 and 2014 were done.Results The total detectable rate of dental fluorosis of children aged 8-12 was 32.31％ (5 803/17 962).The detection rate of 3 counties was lower than 15％,12 counties ranged from 15％ to 30％ and 8 counties more than 30％.Very light,mild,moderate,and severe cases of dental fluorosis cases accounted for 48.39％ (2 808/5 803),30.43％ (1 766/5 803),15.16％ (880/5 803) and 6.01％ (349/5 803).Male and female children's overall detection rate was 33.05％ (3 083/9 329) and 31.51％ (2 720/8 633),the difference was statistically significant (x2=4.86,P ＜ 0.05).The detection rates of dental fluorosis of children aged 8,9,10,11 and 12 were 17.79％ (224/1 259),26.02％ (871/3 348),30.28％ (1 255/4 144),34.07％ (1 595/4 682) and 41.02％ (1 858/4 529),indicating that the detection rate increased with age (x2 =345.78,P ＜ 0.01).After longitudinal comparison of the detection rates of dental fluorosis of children aged 8-12 in 2000,2007 and 2014,we found that 17 counties were gradually decreased (all P ＜ 0.05) except Xiuwen,Weining,Qianxi,Qingzhen,Liuzhi and Xixiu (x2 =0.84,4.19,3.67,5.03,1.98,2.37,all P ＞ 0.05).The ratio of dental fluorosis detection rate ＜ 15％,15％-30％ and ＞ 30％ was accounted for 21.74％ (25/115),32.17％ (37/115) and 46.09％ (53/115),respectively,in the 115 villages.Conclusion The detection rate of dental fluorosis of children aged 8-12 in coal-burning-borne endemic fluorosis areas is significantly dropped,and the comprehensive prevention and control effect is gradually apparent.

Objective To survey on fluorosis awareness of children aged 8 - 12 in coal-burning type endemic fluorosis in key diseased districts of Guizhou Province, and to provide a basis for school health education. Methods In 2014, five towns were selected according to five locations as east, south, west, north and center of 23 key diseased districts of Guizhou Province, one complete primary school in each town was chosen to survey on fluorosis awareness of all the children aged 8 - 12. At the same time, datas of fluorosis knowledge awareness of 23 counties in 2010 were collected and compared with the results of this survey. Results In 2014, the students awareness knowledge on endemic fluorosis was 84.21% (247518/293940). The awareness of 9 counties was higher than 90%, 5 counties ranged from 80% to 90%, and 9 counties lower than 80%. Compared with 2010 (awareness:96.58%), 21.74%(5/23) of the counties with increased awareness, and 78.26%(18/23) of the counties with decreased awareness. In overall qustionnaines object, the awareness rates of fluorosis prevention, correct use of coal-fired stoves, correct maintenance method of coal-fired stoves, method of avoid soot pollution food were 81.91% (48154/58788), 83.72%(82026/97980), 85.11%(66709/78384), and 86.12%(50629/58788), respectively. The awareness rates of children aged 8, 9, 10, 11 and 12 were 80.47%(32359/40215), 83.36%(52581/63075), 85.04%(53882/63360), 84.79% (53328/ 62895), and 85.98% (55368/64395), respectively, the differences were statistically significant (χ2=658.93, P<0.01). The awareness rates of male and female students were 84.35%(128802/152700) and 84.05%(118716/141240), respectively , the difference was not statistically significant (χ2= 3.64, P>0.05).Conclusions The awareness rate of children aged 8 - 12 in key diseased districts of Guizhou Province is decreased. Work on school health education should be continued, to consolidate control outcomes.