Objective:To establish a polymerase chain reaction(PCR)method to accurately discriminate the crude materials and aqueous extract of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorff and Ptyas korros.Methods:Specific primers were designed using mitochondrial Cytb gene(CO1)as a target gene,and annealing temperature,number of cycles and the type of DNA polymerases were optimized.The mixed samples were detected by this method.Results:By this multiplex allele-specific PCR identification method,135,182,246 and 197 bp of specific fragments were amplified from DNA templates of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros,respectively,following the conditions:cycle number of 35,annealing temperature of 62 ℃.The adulterants and the blank control showed no bands.The method could simultaneously and accurately identify the snake-derived components in the mixed samples.Conclusion:The method can be used to identify the samples of Zaocys dhumnades,Elaphe carinata,Elaphe meollendorffi and Ptyas korros simultaneously,accurately and rapidly,and is suitable for the identification of standard decoctiond and formula granules samples.

The aim of this study was to investigate the correlation between porcine epidemic diar-rhea virus(PEDV)S1 IgG antibody levels and neutralizing antibody potency in sow sera.Sera from 5 PEDV-infected farms with a clear immune background,5 non-infected farms and 5 infected farms with an unclear immune background,and sera from return-fed reserve pigs,totaling 716 copies,were collected and measured,and the correlation between PEDV S1 IgG antibodies and neutralizing antibodies was analyzed.The results showed that the PEDV S1 IgG and neutralizing antibodies of sow sera showed highly significant positive correlation,the correlation coefficient was 0.892(P＜0.000 1).Previous studies have shown that the level of PEDV neutralizing antibodies in sow serum correlates with the ability of piglets'maternal antibodies to resist PEDV infection.Therefore,the a-bility of maternal antibodies against PEDV in piglets can be evaluated by detecting PEDV S1 IgG antibodies in the serum of sows.In 10 PEDV-infected farms,the neutralizing antibodies to PEDV in the sera of sows after immunization were generally high,and the S1 IgG antibodies were also high,and their S/P values were higher than 3.5 in 66.9％of the farms(347/519),and the highest anti-body levels were found in the four farms in which PED did not occur,whereas the neutralizing an-tibodies in the immunized sows in the five PEDV-uninfected farms were generally low,and their S1 IgG antibodies were also low,and only 8.1％(13/161)having S/P values higher than 3.5.The re-sults suggest that most sows in PEDV-infected farms can provide good immunoprotection to pig-lets after immunization,while pigs in PEDV-uninfected farms need further immunization if they need to achieve a higher level of immunoprotection.The present study provides a substantial clini-cal basis for the use of PEDV S1 IgG antibody levels to assess the effectiveness of PEDV antibody protection in swine herds.

Objective To investigate the efficacy of dronedarone combined with low dose metoprol-ol in the treatment of atrial tachycardia.Methods A total of 175 elderly patients with atrial tachy-cardia admitted in Northern Jiangsu People's Hospital during January 2020 to January 2022 were enrolled and then randomly divided into dronedarone group(n=57),metoprolol group(n=55)and combined group(dronedarone+metoprolol,n=48).The frequency,duration and symptom changes of arrhythmia were compared before and after treatment.Results After 3 and 6 months of administration,the total effective rate was significantly higher in the combination group than the dronedarone group and the metoprolol group(P＜0.05).The frequency of atrial fibrillation(AF)attacks[(2.31±1.78)/48 h vs(11.56±18.68)/48 h],AF duration[(4.86±6.73)h/48 h vs(10.92±9.61)h/48 h],atrial flutter(AFL)attacks[(2.33±1.53)/48 h vs(4.33±1.53)/48 h]and AFL duration[(5.15±4.87)h/48 h vs(21.54±20.08)h/48 h]in the combined group,and AFL duration[(2.75±1.94)h/48 h vs(10.29±8.04)h/48 h]in the dronedarone group were reduced after 6 months of treatment(P＜0.05).Conclusion In the treatment of atrial tachycardia,dronedarone combined with low dose metoprolol can not only obviously improve symptoms,but also significantly reduce the atrial premature and atrial tachycardia attacks,decrease the number and duration of AF and AFL attacks,and control heart rate effectively.

Objective:To establish an indicator system for surveillance of data sources to provide a theoretical basis for respiratory infectious disease surveillance and early warning.Methods:Indicators for data sources in the surveillance of acute respiratory infectious diseases were initially compiled through a literature search. Subsequently, two rounds of expert consultations were conducted with 22 experts using the Delphi method to refine the indicators.Results:The questionnaire recovery rates for the two rounds of expert consultation were 100.00% and 86.36%, respectively. The authority coefficient of the experts was 0.83. The coordination coefficient of the second round of Delphi expert consultation was 0.32, and the coefficient of variation of each indicator was less than 0.25. Finally, the indicators system of data source for the surveillance of acute respiratory infectious diseases includes 4 first-level indicators, 10 second-level indicators, and 26 third-level indicators.Conclusion:The indicator system of data sources for the surveillance of acute respiratory infectious diseases constructed in this study is reasonable and reliable, providing a valuable reference for surveillance, early warning and policy formulation of acute respiratory infectious diseases.

Objective To investigate the clinical application of dabigatran etexilate in elderly patients with non-valvular atrial fibrillation. Methods Clinical materials of elderly non-valvular atrial fibrillation patients with dabigatran etexilate in the Department of Cardiology of the Subei People's Hospital Affiliated to Yangzhou University from January 2021 to June 2022 were collected, and according to the relevant guidelines, clinical application, laboratory indicators and clinical outcomes were statistically analyzed. Results Among 150 patients, 14 cases had no indications for medication and 12 cases had contraindication; 93 cases had insufficient dosage, 9 cases had excessive dosage, 13 cases had unreasonable frequency of administration, and 20 cases had unreasonable conversion with other anticoagulant drugs. Laboratory indicators indicated a significant increase trend in activated partial prothrombin time (APTT) after 1 month, 3 and 6 months of medication (P < 0.05). Clinical outcome showed that the incidence of ischemic stroke events was 3.33%(4/120), the incidence of massive bleeding was 1.67% (2/120), and the incidence of cerebral hemorrhage events was 0.83% (1/120). Conclusion It is common that clinical dosage of dabigatran etexilate in our hospital is insufficient. Pharmacists should pay attention to the standardized application of dabigatran etexilate in elderly patients.

OBJECTIVE To investigate the influence of Huayu xiaozhong decoction （HXD） on inflammatory response in rats with deep vein thrombosis （DVT）. METHODS The male SD rats were divided into control group （CK group）， model group （Model group）， HXD low-dose group （HXD-L group， HXD 10.86 mg/kg）， HXD medium-dose group （HXD-M group， HXD 21.71 mg/kg）， HXD high-dose group （HXD-H group， HXD 32.57 mg/kg）， positive control group （LMWHS group， low molecular weight heparin sodium 600 IU/kg）， silent information regulator 2 （SIRT2） inhibitor group （AK-7 group， AK-7 20 mg/kg）， HXD-M+AK-7 group （HXD 21.71 mg/kg+AK-7 20 mg/kg）， with 12 rats in each group. Except for the CK group， the DVT rat was induced by the Reyers method in other groups； after modeling， administration groups were given relevant medicine intragastrically/intraperitoneally， once a day， for consecutive 2 weeks. Twenty-four hours after the last medication， the coagulation function indexes [activated partial thromboplastin time （APTT）， thrombin time （TT）， prothrombin time （PT）， fibrinogen （FIB）] and inflammatory indexes in serum and inferior vena cava tissue [interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α）] of rats were detected. The formation of thrombus was observed， and the wet and dry masses of the thrombus were weighed. The protein expressions of tissue factor （TF） and SIRT2 as well as the phosphorylation and acetylation levels of nuclear factor kappa B （NF-κB） p65 in inferior vena cava tissue were detected. RESULTS Compared with CK group， APTT， TT and PT of rats in Model group were shortened significantly（P＜0.05）； the content of FIB， the levels of IL-1β， IL-6 and TNF-α， wet weight and dry weight of venous thrombus， TF protein staining score， the phosphorylation and acetylation levels of NF-κB p65 protein increased significantly （P＜0.05）； the inferior vena cava was full of thrombus， and the protein expression of SIRT2 decreased （P＜0.05）. Compared with Model group， above indexes of HXD-L group， HXD-M group， HXD-H group and LMWHS group were improved， while the improvement effects of HXD-M group， HXD-H group and LMWHS group were significantly better than those of HXD-L group （P＜0.05）. The trends of the corresponding indicators in AK-7 group were opposite to the above （P＜0.05）； AK-7 attenuated the inhibitory effect of medium-dose HXD on the inflammatory response in model rats （P＜0.05）.CONCLUSIONS HXD may inhibit the inflammatory response of DVT rats by activating SIRT2/NF-κB signaling pathway.

Objective:To investigate disease benefit finding of primary caregivers of children with cerebral palsy, in order to provide reference for clinical diagnosis, treatment and nursing of children with cerebral palsy.Methods:Using the phenomenological method of qualitative research, a total of 12 primary caregivers of children with cerebral palsy were selected from the outpatient and inpatient wards of Department of Child Rehabilitation in the Second Affiliated Hospital of Wenzhou Medical University/Yuying Children's Hospital from October 2020 to February 2021 by the purposive sampling method. Semi-structured interviews were conducted to understand the feelings of the primary caregivers when their children were diagnosed with cerebral palsy, how their thoughts changed during care and what coping methods they adopted. Colaizzi 7-step content analysis was used to analyze the collected text data.Results:The disease benefit finding of primary caregivers of children with cerebral palsy was mainly reflected in self-growth (cultivating healthy behaviors, learning to face and accept reality and enhancing emotional regulation), positive prospects for future life (cherishing the present and re-planning life, looking at things from a positive perspective, strengthening beliefs and regaining hope), improvement of interpersonal relationships (closer husband and wife relationship, more harmonious relationship between family members, feeling the care of medical staff and support and understanding from peers) and diversified social support (crowdfunding platforms provided by social welfare projects, government subsidy) .Conclusions:The disease benefit finding of primary caregivers of children with cerebral palsy is mainly manifested in four aspects, including self-growth, changes in life attitudes, improvement of interpersonal relationships and social support. Medical staff can carry out psychological interventions for the main caregivers of children with cerebral palsy from the above four aspects, relieve their negative emotions, improve their psychological adjustment capabilities and enhance their disease benefit finding.

Objective:To explore the changes in activity of indoleamine 2, 3-dioxygenase(IDO)before and after stereotactic body radiation therapy (SBRT) in early stage non-small cell lung cancer(NSCLC) and its relationship with survival.Methods:The retrospective study was to assess IDO activity by serum kynurenine (Kyn) and Kyn to tryptophan (Trp) ratio before and after SBRT of early stage NSCLC.Thirty early stage NSCLC patients who received SBRT in the Cancer Hospital of the University of Chinese Academy of Sciences were enrolled, from December 2014 to July 2017. High-performance liquid chromatography and mass spectrometry were used to detect serum Kyn and Trp before and after SBRT. The ratios of Kyn after SBRT to Kyn before SBRT were divided into high and low group according to the median value. Similarly, the ratios of Kyn to Trp after SBRT were divided into high and low group.The correlation between overall survival (OS), progression-free survival (PFS) and IDO activity was evaluated. The factors influencing prognosis were analyzed.Results:In all patients, lower ratio of Kyn after SBRT to Kyn before SBRT significantly was correlated with better PFS (median PFS: not reached vs. 26.8 months, HR=0.31, 95% CI =0.11-0.90, P<0.05). The lower Kyn∶Trp ratio after SBRT had longer OS (median OS: not reached vs. 36.5 months, HR=0.27, 95% CI =0.079-0.95, P<0.05). In multivariate analysis, smoking <30 packs/year, higher BED, and lower ratio of Kyn after SBRT to Kyn before SBRT were associated with longer PFS. Lower Kyn∶Trp ratio after SBRT and higher BED were associated with longer OS. Conclusions:SBRT could alter IDO-mediated antitumor immune activity. IDO is a potentially valuable biomarker for monitoring immune status and predicting survival in early NSCLC patients after SBRT.

Objective To compare the clinical efficacy of the flaps of modified Limberg and direct incision followed by suture in the treatment of sacrococcygeal pilonidal sinus,aiming to provide the academic guide for its clinical surgery.Methods A total of 76 patients suffered from sacrococcygeal pilonidal sinus were treated with two surgical methods in Department of General Surgery and Department of Burn and Plastic Surgery in Sixth Medical Center of PLA General Hospital from 2013 to 2017.Among these patients,37 cases were resected and reconstructed using the flaps of modified Limberg,the other 39 cases were sutured after beingresected.These patients were followed up during the next 1 or 2 years.Five indexes including surgery period,length of hospital stay,postoperative infection,recurrence and complication,were investigated to statistically compare two different surgery methods' efficacy,using independent t test or chi-square test respectively.Results There were 76 patients in the Limberg flap group and the direct suture group,the operation time was about one and a half hours,and the hospitalization time was about 15 days (P＞0.05);there was no statistical difference between them.There were no complications in 35 of the 37 patients in the Limberg flap group,but skin cracking and infection in 2 patients.In the direct suture group,there were 39 patients,16without complications and 23 with complications,(x2=1133.2393,P=0.0000);there were statistical differences.Among the 37 patients in the Limberg flap group,only one recurred;among the 39patients in the direct suture group,9 recurred (x2=1192.9211,P=0.0000);there were statistical differences.Conclusions Limberg flap incision shows good healing and fewer complications.Within the group of Limberg flap incision healing,only few cases of recurrences occur after the surgery.It not only effectively reduce the complication rate in patients,but also release the pain from long-term,reduplicated medication.The author proposes that this operation should be promoted in the future clinical practice.

Objective To learn the application effects of selective appointment by items of medical care at the endoscope center. Methods Data of the patients receiving gastroscopy examination scheduled by appointment with designated doctors in October through December of 2016 (the control group), and that in January through March scheduled by selective appointment by medical care items ( the improvement group) were selected for comparison.The appointment time, waiting time, workload, secondary waiting time, and patient/doctor satisfaction of the two appointment methods were documented, and compared using independent sample t test, and non-parameter Mann-Whitney U sum of ranks test. Results Compared with the control group, the appointment waiting time of the improvement group [(15.4 ± 2.0)days vs.(24.4 ± 2.2) days], waiting time[(40.0 ± 12.6) min vs.(54.8 ± 15.3) min] were shortened significantly( P<0.05), with much less secondary waiting patients in the improvement groups as well (24.5 ± 7.1 vs. 37.8 ± 9.0, P <0.05 ). Conclusions Design and application of this selective appointment IT system has shortened both appointment and waiting time of patients, securing better medical environment, higher patient satisfaction by means of IT-based and AI-based endoscope appointments.