Objective To explored the correlation between diabetic kidney disease(DKD)and MRI of cerebral small vessel disease(CSVD).Methods 476 type 2 diabetes mellitus(T2DM)patients who were hospitalized in Chengdu University of Traditional Chinese Medicine Affiliated Hospital from January to August 2022 were selected and divided into simple T2DM group(UACR＜30 mg/g,n=330)and DKD group(UACR≥30 mg/g,n=146).General data,biochemical indicators and head MRI images of the two groups were compared.The correlation between DKD and CSVD and the influencing factors of white matter hyperintensities(WMHs)severity were analyzed.Results Age,DM duration,TG,Scr,HbA1c,SUA,cystatin C(Cys C),fibrinogen(Fib)and the incidence of hypertension were higher(P<0.05),while the ALT was lower in DKD group than in T2DM group(P<0.05).Spearman correlation analysis showed tha the presence of DKD was positively correlated with WMHs,lacunar infarction(LI)and brain atrophy(P<0.05).eGFR was negatively correlated with WMHs,LI and brain atrophy(P<0.05).Logistic regression analysis showed that age and HbA1c were the influencing factors for the severity of WMHs.Conclusion Patients with DKD have a higher incidence of CSVD,which may be related to worsening renal function.HbA1c may have predictive value for the severity of WMHs.

【Objective】 To explore the current status and development trend of research on external therapies in traditional Chinese medicine (TCM) for insomnia over the past 10 years through bibliometrics and visual analysis, to provide references for further research on the topic. 【Methods】 Literature relating to TCM external therapies for insomnia from January 1, 2012 to December 31, 2021 was retrieved from Chinese databases, including China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and from the Web of Science Core Collection (WOSCC) for English articles. CiteSpace, VOSviewer, Scimago Graphica, and NoteExpress software were used to analyze publication volumes of the papers and how they were distributed in different journals, as well as to visualize the data of the countries, authors, institutions, and keywords. 【Results】 A total of 6 085 papers were obtained, of which 5 592 were from the Chinese databases and 493 were from the English database, with their publication volumes growing steadily year on year. Approximately 45 countries and regions were found to have published research on the topic. In terms of Chinese publications, the author with the most papers published was CHEN Yunfei from Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine. The closest collaboration was between LIU Chengyong from the Affiliated Hospital of Nanjing University of Chinese Medicine and YUE Zenghui from Hunan University of Chinese Medicine. In terms of English publications, the author with the most papers published was MAO Junj from Sloan-Kettering Cancer Research Center, USA, and LAO Lixing from the University of Hong Kong was his closest partner in collaboration. Heilongjiang University of Chinese Medicine was the institution with the most Chinese publications, and Shanghai University of Traditional Chinese Medicine was the one with the most English papers published. Studies on the topic were published in 386 Chinese journals and 205 English journals, respectively. Nowadays, the clinical application of TCM external treatments for insomnia, the selection of meridians and acupoints, therapies for insomnia and its related diseases are research hotspots. The combined use of different TCM external therapies is a trend in the treatment of insomnia and its concomitant diseases, especially in the fields of oncology, nursing, and psychiatric disorders. The exploration of mechanisms of TCM external therapies for insomnia is also a key direction for future research. In clinical practice, the commonly used external therapies for insomnia include acupuncture, ear-acupressure with beans, acupoint application, etc. The commonly selected acupoints are auricular points, Sishencong (EX-HN1), Shenmen (HT7), etc. The frequently studied meridians are Ren, Du, Qiao, etc. The insomnia concomitant diseases are depression, stroke, anxiety, etc. 【Conclusion】 A wealth of research results have been accumulated in the treatment of insomnia by TCM external therapies, but authoritative research results are not so many. Therefore, institutions in different countries should strengthen communications and cooperation, and researchers should be encouraged to make innovations and breakthroughs on the basis of inherited TCM external therapies, so as to produce more valuable research results and improve TCM external therapies for providing better treatments for patients with sleep disorders.

Rehabilitation medicine is one of the most important specialties in community health institutions. This article introduces the 12 year′s development of rehabilitation medicine in Fenglin Community Health Service Center, focusing on the talent allocation, service capabilities, resource expansion, basic facilities, personnel recruiting, department operating, service scope, and its achievements and influence, to provide reference for planning and construction of featured specialty in community health service centers.

The infectious disease outpatient service as a frontier is an important fulcrum of public health service. Its standardized construction is an important support for ensuring medical safety, reducing nosocomial infections, and controlling the epidemic of infectious diseases. The sub-specialty outpatient service of infection diseases includes fever outpatient service, intestinal outpatient service, tuberculosis outpatient service, AIDS outpatient service, liver disease outpatient service, etc. According to the characteristics of each subspecialty outpatient service and combining with clinical practice, we elaborated the setting norms of subspecialty outpatient service for common infectious diseases from the perspective of planning and design, building layout, equipment and facilities configuration, staffing, daily management and demonstration.

Objective To evaluate the diagnostic value of contrast-enhanced ultrasound in breast precancerous lesions . Methods Retrospectively analyzed the contrast-enhanced ultrasound model and angiographic predictive model of 465 cases of the A prospective multicenter study of breast nodules contrast-enhanced ultrasound" that led the Sichuan Provincial People′s Hospital from January 2016 to April 2017 ,which included 69 cases of breast precancerous lesions and 396 other types benign lesions ,and the sensitivity ,specificity and accuracy of the diagnosis of breast precancerous lesions were calculated . Results The sensitivity of ultrasound predictive model for the diagnosis of precancerous lesions was 60 .9％ and AUC was 0 .681 . Precancerous lesions mainly showed non-concentricity , increased homogeneity , and increased lesions;other types of benign lesions mainly showed non-centripetal ,high uniformity enhancement and lesion size unchanged . Conclusions Contrast-enhanced ultrasound shows a potential value in the differential diagnosis of precancerous lesions and other types of benign lesions ,that can help clinicians to take early intervention measures for breast precancerous lesions ,but there are still many problems to be solved .

OBJECTIVE:To provide reference for rational use of TCM injections. METHODS:Among the inpatients who used TCM injections in 4 hospitals of Shanghai Jiading district in 2013,100 cases were collected by systematic sampling in each hospital separately, and the data were analyzed retrospectively. RESULTS:The varieties and amount of TCM injections for blood-activating and stasis-resolving both occupied the first place. 22% inpatients used two or more TCM injections at the same time. The proportion of overdose use of TCM injections reached 54.55%. The type of unreasonable drug use mainly included drug use against differentiation of syndromes,super indications drugs and solvent error. Combined use of TCM injections with same ef-fect accounted for 20.45% of combined use of TCM injections. CONCLUSIONS:It is effective means to improve rational drug use that great impertance paid for clinical use of TCM injections.

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

Vaccination is one of the most effective and cost-benefit interventions that prevent the mortality and reduce morbidity from infectious pathogens. However, the licensed influenza vaccine induces strain-specific immunity and must be updated annually based on predicted strains that will circulate in the upcoming season. Influenza virus still causes significant health problems worldwide due to the low vaccine efficacy from unexpected outbreaks of next epidemic strains or the emergence of pandemic viruses. Current influenza vaccines are based on immunity to the hemagglutinin antigen that is highly variable among different influenza viruses circulating in humans and animals. Several scientific advances have been endeavored to develop universal vaccines that will induce broad protection. Universal vaccines have been focused on regions of viral proteins that are highly conserved across different virus subtypes. The strategies of universal vaccines include the matrix 2 protein, the hemagglutinin HA2 stalk domain, and T cell-based multivalent antigens. Supplemented and/or adjuvanted vaccination in combination with universal target antigenic vaccines would have much promise. This review summarizes encouraging scientific advances in the field with a focus on novel vaccine designs.
Animals ; Disease Outbreaks ; Hemagglutinins ; Humans ; Influenza Vaccines ; Influenza, Human* ; Mortality ; Orthomyxoviridae* ; Pandemics ; Seasons ; Vaccination ; Vaccines* ; Viral Proteins ; Viruses

Objective To investigate the role of PKCθ signal pathway on regulation of L-selectin (CD62L) expression in human activated γδT cells. Methods Human peripheral blood mononuclear cells (PBMC) were stimulated with Mycobacterium tuberculosis antigen (Mtb-Ag) and cultured for 6-8 d to generate Mtb-Ag activated T cells(MtbAT) as γδT cells enrichment T cell line. The MtbAT were stimulated with PMA or PMA + IMN for 3, 6, 12 and 24 h, respectively, or MtbAT cultured for 8 d were stimulated with Mtb-Ag, or PMA, with or without PKC0 inhibitor Rottlerin for 4 h. After the treated cells stained with fluo-rescent labeled monoclonal antibodies, the expression of CD62L on γδT cells were measured by flow cytome-try (FCM ). Results The expression of CD62L on γδT cells cultured for 6-8 d were 75.0%-87.0%. Decrease of CD62L from the surface of γδT cells by 3 h to 12 h after exposure to PMA (42.3% to 23.5% ), but CD62L expression increased to 53.2% when γδT cells were exposed to PMA for 24 h. The expression of CD62L of γδT cells decreased to 52.1% and 39.3% respectively when γδT cells were exposed to PMA + IMN for 3 h and 6 h. After treated with PMA + IMN for 12 h and 24 h, the expression of CD62L were 52.9% and 35. 3% respectively. The CD62L expression of γδT cells treated with PMA and Rottlerin (47.9%) were higher than that treated with PMA alone (31.8%). After Mtb-Ag restimulated MtbAT for 4 h, the CD62L level of γδT cells decreased from 70.0% to 54.8%, Rottlerin could inhibite Mtb-Ag down regulation CD62L level of γδT cells (63.1%). Conclusion The CD62L expression of γδT cells could be ingibited partly by the inhibitor of PKCθ signal pathway may regulate L-selectin (CD62L) expression of activated human γδT cells.

Objective To investigate the influence of nicotine on the metabolism of dopamine (DA) in the striatum and on the spontaneous locomotor activity of MPTP-induced PD mice. Methods 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD model in mice was prepared. The effects of MPTP and nicotine on the levels of dopamine, its metabolites of 3,4-dihydroxyphenlacetic acid (DOPAC) and hemovanillic acid (HVA) were analyzed with high-performance liquid chromatography and electrochemical detection(HPLC-EC); also, tyrosine hydroxylase (TH)-positive nerve fibers were measured by immunohistochemical analysis. Results After injection of Nicotine, the spontaneous locomotor activity of MPTP-treated C57BL mice was significantly lower than that of the control mice, suggesting the nicotine's inhibiting effects ( 44.86?8.51 vs. 57.28?3.27, P