This paper summarizes Professor WANG Xiuxia's clinical experience in treating hyperprolactinemia using the liver soothing therapy. Professor WANG identifies liver qi stagnation and rebellious chong qi （冲气） as the core pathomechanisms of hyperprolactinemia. Furthermore， liver qi stagnation may transform into fire or lead to pathological changes such as spleen deficiency with phlegm obstruction or kidney deficiency with essence depletion. The treatment strategy centers on soothing the liver， with a modified version of Qinggan Jieyu Decoction （清肝解郁汤） as the base formula. Depending on different syndrome patterns such as liver stagnation transforming into fire， liver stagnation with spleen deficiency， or liver stagnation with kidney deficiency， heat clearing， spleen strengthening， or kidney tonifying herbs are added accordingly. In addition， three paired herb combinations are commonly used for symptom specific treatment， Danggui （Angelica sinensis） with Chuanxiong （Ligusticum chuanxiong）， Zelan （Lycopus lucidus） with Yimucao （Leonurus japonicus） ， and Jiegeng （Platycodon grandiflorus） with Zisu （Perilla frutescens）.

Objective:To investigate the protective effect and mechanism of 4-octyl itaconate(4-OI)on vascular endothelial function in diabetic mice,since endothelial dysfunction is the key and initial factor for vascular complications in diabetes.Methods:The db/db mice were used to establish a mouse model of diabetes,and high glucose(HG)-induced human umbilical vein endothelial cells(HUVECs)were used to establish a cell model of diabetes.After 4-OI treatment,HE staining,Masson staining,and reticular fiber staining were used to observe pathological changes of the thoracic aorta in the control group,the model group,and the intervention group;Western blot was used to measure the expression of α-smooth muscle actin(α-SMA),a marker for endothelial fibrosis;immuno-fluorescence assay was used to measure the expression levels of Bcl-2-associated X protein(BAX)and B-cell lymphoma-2(Bcl-2)in the thoracic aorta of mice in the control group,the model group,and the intervention group;immunoblotting was used to observe the effect of 4-OI intervention on the expression of BAX,Bcl-2,and the proteins associated with the cytochrome C(CytC)/cysteinyl aspartate specific proteinase(caspase)pathway in HG-induced HUVECs.Results:The results showed that 4-OI could significantly improve vascular endothelial dysfunction in db/db diabetic mice.Compared with the model group,the intervention group had a significant increase in the expression of Bcl-2(0.73±0.07 vs.0.52±0.04,F=49.380,P=0.009)and a significant reduction in the expression of BAX(1.41±0.14 vs.1.89±0.12,F=37.270,P=0.008)after 4-OI treatment.In the cell model of HUVECs induced by HG,compared with the high glucose group,the intervention group had a sig-nificant increase in the expression of Bcl-2(1.22±0.04 vs.0.81±0.09,F=75.410,P<0.001)and a significant reduction in the expres-sion of BAX(0.83±0.04 vs.1.12±0.04,F=268.100,P<0.001)after 4-OI treatment,as well as significant reductions in the expres-sion of CytC(0.61±0.03 vs.1.01±0.03,F=234.000,P<0.001),caspase-9(0.62±0.03 vs.1.04±0.04,F=164.300,P<0.001),and caspase-3(0.92±0.06 vs.1.74±0.04,F=424.100,P<0.001).Conclusion:In conclusion,4-OI inhibits vascular endothelial cell apoptosis in diabetic mice by affecting the expression of the CytC/Caspase pathway factors,thereby improving vascular endothelial dys-function in diabetes.

To explore the effectiveness of "near peer learning" (NPL) in the electromyography(EMG)teaching module for neurology residents.

Objective To predict the potential suitable habitat of Haemaphysalis concinna in Heilongjiang Province under different climatic scenarios. Methods The geographic locations of ticks in Heilongjiang Province from 1980 to 2022 were captured from literature review and field ticks monitoring data from Harbin Center for Disease Control and Prevention in Heilongjiang Province, and the tick distribution sites with spatial correlations were removed using the software ArcGIS 10.2. The environment data under historical climatic scenarios from 1970 to 2000 and the climatic shared socioeconomic pathways (SSP) 126 scenario model from 2021 to 2040 and from 2041 to 2060 were downloaded from the WorldClim website, and the elevation (1 km, 2010), population (1 km grid population dataset of China, 2010) and annual vegetation index (1 km, 2010) data were downloaded from the Resource and Environmental Science and Data Center, Institute of Geographical Sciences and Natural Resources, Chinese Academy of Sciences. The contribution of environmental factors to H. concinna distribution was evaluated and environmental variables were screened using the software MaxEnt 3.4.1 and R package 4.1.0, and the areas of suitable habitats of H. concinna and changes in center of gravity were analyzed using the maximum entropy model in Heilongjiang Province under different climatic scenarios. In addition, the accuracy of the maximum entropy model for prediction of H. concinna distribution was assessed using the area under curve (AUC) of the receiver operating characteristic curve. Results A total of 79 H. concinna distribution sites and 24 environmental variables were collected, and 70 H. concinna distribution sites and 9 environmental factors that contributed to distribution of the potential suitable habitats of H. concinna in Heilongjiang Province were screened. The three most significant contributing factors included precipitation seasonality, annual precipitation, and mean temperature of the driest quarter, with cumulative contributions of 60.7%. The total area of suitable habitats of H. concinna was 29.05 × 10⁴ km² in Heilongjiang Province under historical climatic scenarios, with the center of gravity of suitable habitats located at (47.31° N, 129.16° E), while the total area of suitable habitats of H. concinna reduced by 0.97 × 10⁴ km² in Heilongjiang Province under the climatic SSP126 scenario from 2041 to 2060, with the center of gravity shifting to (47.70° N, 129.28° E). Conclusions The distribution of suitable habitats of H. concinna strongly correlates with temperature and humidity in Heilongjiang Province. The total area of potential suitable habitats of H. concinna may appear a tendency towards a decline with climatic changes in Heilongjiang Province, and high-, medium- and low-suitable habitats may shift.

Objective:To discuss the surgical strategies of atlantoaxial dislocation in children with mucopolysaccharidosis IVA.Methods:8 cases of atlantoaxial dislocation in children with mucopolysaccharidosis IVA treated with posterior atlantoaxial reduction, decompression, bone graft and internal fixation from April, 2019 to October, 2020 were retrospectively analyzed, including 6 males and 2 females, aged 6.2±3.1 years (range, 2-10 years). All the 8 children had lower limb weakness and walking instability, and some of them could not even stand and walk, and all of them had odontoid hypoplasia, atlantoaxial dislocation and systemic skeletal dysplasia. Measures, including American Spinal injury Association (ASIA) grade, modified atlanto-dental interval (mADI) and reduction rate, screw placement type and fusion of bone graft, were recorded and analyzed.Results:The follow-up time was 17.8±7.4 months (range, 8-27 months). The total operation time was 144.0±43.1 mins (range, 90-220 min) and the blood loss during the surgery was 89.1±55.1 ml (range, 15-180 ml). The ASIA grade were 3 cases of "C" level, 4 cases of "D" level and 1 case of "E" level before the operation, and 1 case of "C" level, 1 case of "D" level and 6 cases of "E" level at the latest follow-up. The mADI reduced from 7.38±2.62 mm pre-surgery to 2.50±1.60 mm ( t=5.71, P=0.001). The reduction rate of the latest follow-up mADI was 65.0%±26.3%. 31 pedicle screws were inserted, including 26 Type I screws (83.9%), 4 Type II screws (12.9%) and 1 Type III screw (3.2%), and no injury of spinal cord or blood vessels were observed associated with the Type III screw. One unilateral axial lamina screw was used in 1 case. 5 patients showed fusion (autogenous bone) 6 months after the surgery, 2 patients got fusion (allogeneic bone) 1 year after the surgery, and other patients showed bone graft resorption (allogeneic bone) at the latest follow-up. One patient developed type II respiratory failure on the night of operation and recovered after rescue. Other patients had no complications such as vascular and nerve injury, screw loosening and so on. Conclusion:The majority of children with type IVa mucopolysaccharidosis are accompanied by absence of odontoid process. If such children are complicated with atlantoaxial dislocation and cervical spinal canal stenosis resulting in cervical spinal cord injury, timely surgical intervention should be carried out. Posterior atlantoaxial fusion is a safe and effective surgical method. As children have the characteristics of multi-system involvement, multi-disciplinary cooperation may be needed to ensure perioperative safety.

Objective: To explore the relationship between left-behind experience, sleep quality and depression in college students and to provide a scientific reference for improving mental health of college students. Methods: The stratified cluster sampling method was used to investigate depression and related factors among undergraduates at two universities in Qiqihar City from November to December 2018, and the effects of left-behind experience and sleep quality on depression were analyzed. Results: Depression detection rate of college students in Qiqihar City was 30.62%, there was no difference in the detection rate of depression among college students of different sex( χ 2=3.15, P >0.05), depression detection rate of college students from rural area was higher than in urban students, non-only child higher than onlychild( χ 2=8.61, 8.98, P <0.05). Multivariate Logistic regression showed that left-behind mode, left-behind age, type of stay-at-home, frequency of contact with parents during stay, and sleep quality were associated with depression( OR =0.28-6.00, P <0.05). Conclusion Depression of college students is associated with previous left-behind experiences and sleep quality.

This study aimed at the quality and safety improvements of surgical services in terms of preoperative, intraoperative and postoperative sections, and at establishing corresponding restraint standards. To this end, such methods as literature analysis, dispute case analysis, surgical adverse event analysis, and system standard interpretation as well as clinical experts survey were called into play, to identify key elements in terms of the universality, high-prevalence rate, criticality and impact degree. A standard framework is established focusing on surgical service and such nodes as key components of the event; a standard text on surgical service quality and safety management is developed, comprising three sections, 8 nodes, 27 key elements and 82 standards.

Objective:To investigate the effects of Zinc sulfate on preventing human umbilical veins endothelial cells ( HUVECs) from oxidative stress. Methods:Hydrogen peroxide was used to stimulate HUVECs to build the oxidative stress model in vitro. HUVECs were divided into normal group, H2 O2 group, Zinc sulfate group and Zinc sulfate treated group. Method of nitrate reductase was used to detect the content of nitric oxide ( NO ) and ELISA was used to detect the content of endothelin ( ET ) in supernatant in different groups. The level of HO-1,SOD and CAT of HUVECs were measured by Western blot. Apoptosis of HUVECs was examined by TUNEL as well. Results: Zinc sulfate could enhance the content of NO and decrease the content of ET in the supernatant,which induced by hydrogen peroxide on HUVECs. Zinc sulfate could also increase the level of HO-1, SOD and CAT obviously and decrease the apoptosis cells significantly induced by H2 O2 . Conclusion: Zinc sulfate play an important role in resisting oxidative stress in HUVECs, and maybe prevent HUVECs from oxidative stress damage. Zinc sulfate is expected to be an effective medicine on improving endothelial cells anti-oxidative ability.

Objective: To investigate the average dietary nutrients intake status among Chinese residents between 2010-2012, and to compare the difference between rural and urban areas. Methods: Data were collected from Chinese Nutrition and Health Surveillance between 2010-2012. Based on regional features and economic development levels, China's county-level divisions were classified into four types: big city, medium and small city, ordinary rural area and poor rural area. A total of 62 857 valid subjects, including 14 017, 16 539, 19 910 and 12 391 respondents in each group separately, were enrolled by Multi-stage stratified proportion to the population cluster random sampling method. The dietary survey was conducted by recalling the 24 h diet in 3 consecutive days and weighting condiment. The daily dietary intake of energy, macronutrient, dietary fiber, vitamin, and mineral substance per resident were calculated based on China Food Composition. Results: The average energy intake per resident in Mainland China was 9 047.1 kJ, with highest (9 719.3 kJ) in poor rural area and lowest (8 490.4 kJ) in medium and small city. The average dietary protein intake was 64.2 g, with highest (73.9 g) in big city and lowest (60.7 g) in poor rural area. The average dietary fat intake was 79.7 g, with highest (89.4 g) in big city and lowest (70.6 g) in poor rural area. The average intake of micronutrients of vitamin A, vitamin B₂, vitamin C, calcium, iron, phosphorus, zinc was separately 441.9 μg, 0.8 mg, 80.1 mg, 364.3 mg, and 21.4 mg; which were lower than Chinese Dietary Reference Intakes. The percentage of population whose average intake of vitamin A, vitamin B₂, vitamin C, calcium were lower than estimated average requirement was separately 77.0%, 90.2%, 67.7%, and 96.6%. Conclusion The supply of 3 macronutrient was sufficient in mainland China. However, it was a common issue that there was excessive intake of fat but deficient intake of micronutrients such as vitamin, calcium, iron and zinc. There were differences in nutrition intake among big city, medium and small city, ordinary rural area and poor rural area.

Notch signaling pathway is involved in oogenesis and the secretion of ovarian hormones .It controls prolifera-tion and differentiation of ovarian stem cells .In addition, the Notch pathway is also involved in ovarian carcinogenesis .