The outbreak of COVID-19 has exposed many shortcomings in disease control and prevention system (DCPS) of China. Resolving the problems and strengthening the DCPS became the top priority in China’s public policy agenda. This paper revealed the problems of the system regarding policy-making, regulations, operation mechanism and staff, and proposed several strategies from three aspects of legal construction, management system, and operation mechanism, including: 'Prevention first' should be incorporated into the national legal system, all the departments should be engaged in 'Healthy China 2030' initiative, laws and regulations should be amended, new disease prevention and control management institutions should be set up, a high-quality professional team should be retained, the regional health information exchange channels should be strengthened, the coordinated mechanism for disease prevention and control should be normalized, the long-term investment mechanism should be established, and the equipment renewal and reserve system should be improved.

Objective To study the correlation between histological chorioamnionitis (HCA),prenatal corticosteroids and early brain injury of preterm infants.Method From December 2014 to December 2016,preterm infants with gestational age ≤ 34 weeks admitted to our hospital and umbilical cord blood samples taken immediately after birth were reviewed.According to the results of pathological examination of their mother's placenta and the use of glucocorticoids (GCs),they were assigned into HCA+ GCs + group,HCA + GCs-group,HCA-GCs-group,and HCA-GCs +group.The levels of lnterleukin-6 (IL-6),hepcidin,erythropoietin (EPO),human activin A (ACV-A),S-100β protein,and CC-chemokine ligand 18 (CCL18) in premature infants' umbilical cord blood in each group were tested using ELISA method.The incidences of premature infants' early brain injury and the correlation with inflammatory factors in each group were analyzed.The ROC curve was used to analyze the sensitivity and specificity of S-100β protein and IL-6 level in predicting early brain injury in preterm infants with placenta inflammation.Result A total of 343 infants with gestational age ≤ 34 weeks and their umbilical cord blood samples were tested.Among the 343 premature infants,47.1％ suffered from early brain injury (98/208) in the HCA+ group;while 27.4％ suffered from early brain injury (37/135) in the HCA-group,the difference was statistically significant between the two groups (P ＜ 0.001).A total of 142 cases received prenatal GCs treatment,and 41 (28.9％) cases had early brain injury.201 cases didn't receive prenatal GCs treatment,and 94 (46.8％) had early brain injury.The differences between the two groups were also statistically significant (P=0.001).The incidence of early brain injury in the HCA+GCs-group was significantly higher than the HCA+GCs+ group,HCA-GCs-group and HCA-GCs+ group(P＜0.05).The S-100β protein and IL-6 level in umbilical cord blood of the HCA+GCs-group and HCA+GCs+ group were higher than the HCA-GCs-group(P＜0.05).The area under the ROC curve for IL-6 predicting early brain injury in preterm infants was 0.732 (95％CI 0.675～0.789,P＜0.05).The cut-off value of 213.45 pg/ml of IL-6 (was selected to predict the risk of early brain injury with the sensitivity of 41.9 ％ and the specificity 99.0 ％.The area under the ROC curve for S-100β protein was 0.511 (95％CI 0.449～0.574,P=0.723).Conclusion Placental inflammation and insufficient prenatal glucocorticoids treatment are closely related to the occurrence of early brain injury in preterm infants.S-100β protein and IL-6 in umbilical cord blood may play an important role in early brain injury of premature infants.The IL-6 level has a higher predictive value for early brain injury,while S-100β protein level has a less predictive value.

Aesculus chinensis belongs to Hippocastanaceae family,bears medicinal and ornamental values. The oleanane type triterpenoid saponin aescin is regarded as active ingredient and accumulated in seed. In order to understand its molecular basis of the triterpenoid biosynthesis,we used high-throughput sequencing under Illumina Hi Seq 2000 platform to obtain the transcriptome data of seed and flower from A. chinensis to further mine the genes involved in its metabolic pathway. Unigene's de novo splicing was performed using Trinity software; the transcriptome results were annotated with KEGG database to predict the specific pathways of the aescin triterpenoid metabolism. Terpenoid and triterpenoid pathways were found from transcriptome data,and forty seven and twenty seven corresponding genes were uncovered respectively. It was found that there are eight kinds of enzymes related to the terpenoid metabolism pathway precursors and three kinds of enzymes related to the triterpenoid metabolism pathway. In this study,five genes corresponding to triterpene cyclase were analyzed in A. chinensis for the first time,which may participate in the synthesis of triterpenoid. It' s revealed that there were thirty three differential genes associated with the ko00900 and ko00909 pathways by analysis on the difference in transcriptome expression between seeds and flowers; seventeen unigenes were up-regulated and sixteen unigenes were down-regulated in the seeds relative to flowers. In this study, qRT-PCR experiments were used to verify the expression of three key enzyme genes of SQE( Unigene25806),HMGS( Unigene36710),and β-AS( Unigene33291). The results of qRT-PCR were consistent with the transcriptome data. The candidate genes related to triterpenoid saponin aescin synthesis in A. chinensis found in this study can provide theoretical basis for the metabolism synthesis and regulation of aescin.
Aesculus ; Flowers ; Gene Expression Profiling ; Saponins ; Transcriptome ; Triterpenes

Objective: To investigate the current harvest,processing,packaging and storage of Lilii Bulbus due to the great difference in quality of commercially available products,in order to realize the factors affecting the quality after harvest and provide reference for the standardized production. Method: A series of factors affecting Lilii Bulbus quality were analyzed comprehensively on the basis of both field survey in main producing areas and medicinal material markets and literature retrieval. Result: The current situation and problems in harvest,initial processing,drying technologies,packaging,and storage were summarized. Conclusion: The harvest link of Lilii Bulbus involves growing years,harvesting time,and collecting methods. The initial processing link involves stripping,cleaning,sulfur fumigation,and many cooking and drying methods. The hot-air,vacuum-freeze,far-infrared,and microwave methods are applied in drying Lilii Bulbus. The main metamorphic phenomena are brown staining,moth biting,and decay in the packaging and storage links. Lilii Bulbus are packed mainly in bulk,and a few of them are packed in plastic bags or vacuum bags for fresh bulbus. Because the operation process is not standard,the cooking and drying methods are the key factors affecting the quality of Lilli Bulbus. It is necessary to establish a scientific and unified standard operating procedure (SOP) for controlling the whole process of Lilii Bulbus in multiple links.

Objective: Ganoderma sinense is one of the most famous medicinal fungi in China. Because it is a model medicinal fungus of basidiomycete,the functional identification of its sesquiterpene synthase is of great significance for the biosynthesis and regulation studies of fungal sesquiterpene. Method: A sesquiterpene synthase gene was discovered by mining the genome data of G. sinense. The sesquiterpene's conservative motifs was analyzed through multiple sequence alignment with two identified sesquiterpene synthases of G. sinense and three terpenoid synthases in the Nr database,which have the highest similarity to it. Subsequently,heterologous expression was observed in Escherichia coli,and protein expression was detected by SDS-PAGE. Volatile compounds were collected by solid phage microextraction (SPME) and detected by GC-MS. Result: The enzyme containing sesquiterpene conserved motifs DDXXDE and NSE/DTE were efficiently expressed in E. coli,and 11 sesquiterpenes were synthesized with endogenous FPP as the substrate. The product α-cadinol at 18.6 min was considered to be the main product,and previous studies showed a significant anticancer activity. According to the comparison with chemical standards,three products were identified as γ-muurlene,α-muurolene and δ-cadinene,respectively. Conclusion: The functional identification of multi-product sesquiterpene synthase from G. sinense can promote the study on the mechanism underlying its product diversity,and lay a foundation for the production of rare or novel sesquiterpenes by improving the catalytic activity of enzymes with enzyme engineering technology.

Background: Malignant pleural effusion (MPE) is a complicated condition of patients with advanced tumors. Further dissecting the microenvironment of infiltrated immune cells and malignant cells are warranted to understand the immune-evasion mechanisms of tumor development and progression. Methods: The possible involvement of microRNAs (miRNAs) in malignant pleural fluid was investigated using small RNA sequencing. Regulatory T cell (Treg) markers (CD4, CD25, forkhead box P3), and Helios (also known as IKAROS Family Zinc Finger 2 [IKZF2]) were detected using flow cytometry. The expression levels of IKZF2 and miR-4772-3p were measured using quantitative real-time reverse transcription polymerase chain reaction. The interaction between miR-4772-3p and Helios was determined using dual-luciferase reporter assays. The effects of miR-4772-3p on Helios expression were evaluated using an in vitro system. Correlation assays between miR-4772-3p and functional molecules of Tregs were performed. Results: Compared with non-malignant controls, patients with non-small cell lung cancer had an increased Tregs frequency with Helios expression in the MPE and peripheral blood mononuclear cells. The verified downregulation of miR-4772-3p was inversely related to the Helios⁺ Tregs frequency and Helios expression in the MPE. Overexpression of miR-4772-3p could inhibit Helios expression in in vitro experiments. However, ectopic expression of Helios in induced Tregs reversed the effects induced by miR-4772-3p overexpression. Additionally, miR-4772-3p could regulate Helios expression by directly targeting IKZF2 mRNA. Conclusion Downregulation of miR-4772-3p, by targeting Helios, contributes to enhanced Tregs activities in the MPE microenvironment.

Objective: To study the clinicopathological characteristics, immunophenotype, pathologic diagnosis and differential diagnosis of diffuse pulmonary meningotheliomatosis (DPM). Methods: The clinical data, histological features and immunohistochemical results of three cases of DPM collected from January 2016 to May 2018 at Guangdong Provincial People′s Hospital were analyzed, and the relevant literature reviewed. Results: The three DPM patients age was 53, 69 and 74 years. The lesions consisted of multiple minute pulmonary meningothelial-like nodules profusely involving the lungs. Microscopically, they showed typical morphology, characterized by medium-sized elongated tumor cells resembling meningothelial cells with whorled/nested clusters. The cells were uniform and had abundant eosinophilic cytoplasm with oval nuclei with delicate chromatin. Immunohistochemical staining showed tumor cells were diffusely and strongly positive for EMA, vimentin and PR, but were negative for CAM5.2, CgA, Syn, CK7 and TTF1. Conclusions DPM is extremely rare, and may be confused with primary interstitial pulmonary processes and metastatic malignant tumors of lung. Recognition of this entity is essential for pathologists to avoid misdiagnosis and unnecessary treatment.

Objective:To explore therapeutic effect of percutaneous coronary intervention(PCI)combined tirofiban hydrochloride on aged patients with acute ST elevation myocardial infarction(ASTEMI)and its influence on cardiac function and myocardial microcirculation.Methods:A total of 90 aged ASTEMI patients undergoing PCI in our hospital from Jul 2013 to Mar 2016 were selected.According to hospitalization order,they were randomly and e-qually divided into pure PCI group and combined treatment group(received tirofiban based on pure PCI group), both groups were treated for one month.ST segment regression degree,corrected TIMI frame count(CTFC)and TIMI flow grade after PCI,contrast agent acoustic peak intensity in myocardial microcirculation(PI)and serum CK-MB peak concentration before and after PCI,LVEF,LVEDd and LVEDV before and six months after PCI, and incidence rate of adverse events were measured and compared between two groups.Results:Compared with pure PCI group after PCI,there were significant rise in ST segment regression degree[(43.8 ± 7.1)% vs.(66.2 ± 8.2)%],TIMI flow grade[(2.1 ± 0.5)grade vs.(2.9 ± 0.6)grade]and PI[(7.1 ± 1.1)vs.(8.6 ± 1.2)],and sig-nificant reductions in CTFC[(27.3 ± 8.0)frame vs.(18.9 ± 6.6)frame],and serum CK-MB peak level[(296.5 ± 58.1)U/L vs.(199.3 ± 32.4)U/L]in combined treatment group,P= 0.001 all.Compared with pure PCI group on six months after PCI,there was significant rise in LVEF[(54.2 ± 8.3)% vs.(61.1 ± 8.0)%],and signifi-cant reductions in LVEDd[(48.1 ± 7.7)mm vs.(41.3 ± 8.1)mm]and LVEDV[(85.4 ± 10.6)mm3vs.(80.2 ± 10.4)mm3]in combined treatment group,P<0.05 or <0.01.Total incidence rate of adverse events of com-bined treatment group was significantly lower than that of pure PCI group(8.89% vs.26.67%),P=0.001.Con-clusion:PCI combined tirofiban hydrochloride can significantly improve myocardial microcirculation and cardiac function with low incidence rate of cardiovascular adverse events.The mechanism may be related to improving effect of tirofiban hydrochloride on myocardial microcirculation.

Objective Transplantation of bone marrow mesenchymal stem cells (BMSCs) has a good prospect of application for cerebral infarction,but the environment and the inflammatory response to ischemia and hypoxia after cerebral infarction are not con-ducive to the survival of transplanted cells. This article investigated the effects of Shuxue Tongmai capsule(SXTM) combined with BM-SCs transplantation on the improvement of cerebral ischemic injury in rats. Methods A model of middle cerebral artery occlusion was es-tablished in Sprague-Dawley(SD) rats using thread method and these 15 SD rats were randomly divided into model group,BMSCs group and combination therapy group (BMSCs transplantation combined with SXTM treatment). At 24h after modeling,rats in combination therapy group were given tail vein injection of 1 mL BMSCs suspension (2× 109 per/L) and gavage administration of SXTM 0. 64 g/kg. Rats in BMSCs group were given tail vein injection of 1 mL BMSCs suspension (2×109 per/L) and gavage administration of equal volume of sa-line. For model group,the rats were given tail vein injection of equal volume of PBS and gavage administration of equal volume of sa-line. Neurologic function was assessed before cell transplantation and at 3,7,14,28 days after cell transplantation to check the injury of neurologic function. At 28 days after transplantion,the rats were decapitated after anesthesia to take brain tissues for immunohisto-chemical detection of vascular endothelial growth factor(VEGF) and brain-derived neurotrophic factor(BDNF) protein expression. Mor-phological changes of the brain tissue and apoptosis in cortical neurons were observed and detected by hematoxylin-eosin staining and TUNEL,respectively. Results At 7,14,28 days after transplantation,the neurological defect score in combination therapy group was significantly lower than those of model group and BMSCs group(P<0.05). In each group,the neurological defect score at 3 days after transplantation was significantly decreased compared with those before transplantation(P<0.05). In the same group,the neurologi-cal defect scores at 14,28 days after transplantation were significantly decreased compared with those at 7 days after transplantation (P<0.05). The neurological defect scores at 14,28 days after transplantation were significantly decreased compared with those at 7 days after transplantation(P<0.05). The neurological defect score at 28 day after transplantation was significantly decreased compared with that at 7 day after transplantation(P<0.05). At 28 day after transplantation,the number of apoptotic cells in combination therapy group (51.40±4.04) was significantly fewer than those of model group (74.80±5.31) and BMSCs group (67.20±4.66) and the num-ber of apoptotic cells in BMSCs group was significantly decreased compared with model group(P<0.05). The results of immunohisto-chemistry showed that the VEGF and BDNF positive cells in the cerebral ischemic region of rats were brownish or sepia in color. Com-pared with model group,the expression levels of VEGF and BDNF protein in BMSCs group and combination therapy group were signifi-cantly increased (P<0.05),and that of combination therapy group was significantly increased compared with BMSCs(P<0.05). Conclusion SXTM combined with BMSCs transplantation can promote neurological recovery from cerebral ischemia by increasing the protein expression of VEGF and BDNF and reducing neuronal apoptosis.

OBJECTIVEEstablishing a rabbit model of vertebral artery type of cervical spondylosis(CSA) and to observe the characteristics of timeliness in improving the blood flow of vertebral artery by massage, and discusse the material basis of this timeliness based on NPY and ET-1.

METHODSFifty New Zealand healthy and white rabbits, 6-month-old, the body mass of (2.0±0.5) kg, with half males and half females, were randomly divided into blank group, model group, three massage groups(including massage for 10 min, 20 min, and 30 min group by random number table), 10 rabbits in each group. In addition to the blank group, CSA rabbit model was made by injection of sclerosing agent in other groups. The rabbits of massage for 10 min, 20 min, and 30 min groups received the massage therapy of corresponding duration, one times a day, continuous 10 days. The blood flow of vertebral artery in each group was detected by PeriFlux5000 laser doppler, and the contents of NPY and ET-1 in serum were detected by ELISA before and after treatment.

RESULTSChanges in blood flow of vertebral artery before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of NPY content before and after treatment: there was significant difference between model group and massage for 10 min group(<0.05); there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of ET-1 content before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(<0.01); there was significant difference between massage for 10 min group and massage for 20 min, 30 groups (<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group.

CONCLUSIONSMassage needed 20 min for rabbits with CSA can only significantly improve the blood flow of vertebral artery. However, prolonging the time of massage has no obvious effect. The material basis of this timeliness characteristic of massage is closely related to the change of NPY and ET-1 levels in serum.