Acute respiratory distress syndrome (ARDS) is the leading cause of respiratory failure with high morbidity and mortality. Pulmonary surfactant (PS)-based complementary therapies have exhibited potential for ARDS healing and applied as an adjunctive therapy strategy. Coacervate (Coac) has the characteristics of softness, deformability and excellent molecular enrichment properties, and has attracted extensive attention in the biomedical field. Here PS and coacervate were combined for the potential ARDS treatment. The Coac, fabricated from polyallylamine hydrochloride (PAH) and adenosine triphosphate (ATP) by simple mixing, exhibited soft droplet property and high enrichment for dexamethasone sodium phosphate (DSP). To avoid the fusion effect of membraneless coacervate and endow it with biological functions of PS, liposomes with PS-biomimetic lipid components (PS-lipo) were further introduced to construct PS-biomimetic membranized coacervate (DSP@PS-Coac). The DSP@PS-Coac demonstrated high lung targeting effect and significant penetration efficiency after intravenous injection. Furthermore, PS-lipo replenished the endogenous PS pool and facilitated the distribution of DSP in inflammatory cells in the lung. In the ARDS mouse model, PS-Coac and DSP exerted synergetic anti-inflammatory functions, via reducing the recruitment of inflammatory neutrophils and modulating macrophages into anti-inflammatory phenotype. The overall results confirmed that DSP@PS-Coac may provide a promising delivery option for the treatment of ARDS.

Objectives:To investigate the clinical efficacy of Schroth scoliosis-specific exercises combined with three-dimensional traction therapy in spinal-pelvic remodeling for adolescents idiopathic scoliosis(AIS).Methods:80 AIS patients who received treatment at our hospital from June 2021 to June 2024 were en-rolled.They were randomly divided into a control group(n=40,received Schroth spinal scoliosis-specific cor-rection exercises alone)and a research group(n=40,underwent a combination of Schroth spinal scoliosis-spe-cific correction exercises and three-dimensional traction therapy)using a random number table method.The general demographic data of the two groups were well-balanced(P＞0.05).The clinical overall response rates of the two groups were compared,and spinal-pelvic remodeling indicators,including Cobb angle,angle of trunk inclination(ATI),angle of trunk rotation(ATR),C7 plumb line to the center sacral vertical line(C7-CSVL),api-cal vertebral translation(AVT),as well as median frequency(MF),mean power frequency(MPF),and average electromyography(AEMG)of the surface electromyography of the erector spinae muscles on the concave and convex sides,pelvic tilt(PT),pelvic incidence(PI),and sacral slope(SS),were assessed before treatment,at 1 month and 3 months after treatment.Repeated measures analysis of variance was conducted to test the main effects of spinal-pelvic remodeling indicators during the treatment period for both groups.Pearson correlation analysis was performed to examine the relationship between the Oswestry disability index(ODI)score and spinal-pelvic remodeling indicators.Results:The total effective treatment rate was significantly higher in the research group than in the control group(97.50％vs 67.50％,P＜0.001).Compared with the pre-treatment val-ues,the Cobb angle,ATI,and ATR of both groups decreased at 1 month and 3 months post-treatment(P＜0.05).Moreover,when compared with the control group,the research group showed a more pronounced de-crease in Cobb angle,ATI,and ATR at 1 month and 3 months post-treatment(P＜0.05).Both groups exhibited a decrease in PI and SS,along with an increase in PT at 1 month and 3 months post-treatment(P＜0.05).In comparison with the control group,the research group demonstrated a more significant decrease in PI and SS,and a more pronounced increase in PT at 1 month and 3 months post-treatment(P＜0.05).The C7-CSVL and AVT of both groups decreased at 1 month and 3 months post-treatment(P＜0.05),and the research group showed a more significant decrease in C7-CSVL and AVT compared with the control group at 1 month and 3 months post-treatment(P＜0.05).Both groups experienced an increase in MF,MPF,and AEMG of the sur-face electromyography of the erector spinae muscles at 1 month and 3 months post-treatment(P＜0.05),with the research group showing a more significant increase compared with the control group at 1 month and 3 months post-treatment(P＜0.05).The main effect tests revealed statistically significant time effects,inter-group effects,and interaction effects for the spinal-pelvic remodeling indicators during the treatment period(P＜0.05).The Cobb angle,ATI,ATR,C7-CSVL,AVT,MF,AEMG,MPF,PI,PT,and SS were all found to be corre-lated with the ODI score before and after treatment(P＜0.05).The decrease in the ODI score of study group after treatment was significantly better than that of control group(β=-6.178,P＜0.001).Conclusions:Schroth scoliosis-specific exercises combined with three-dimensional traction therapy significantly improve spinal-pelvic remodeling in AIS patients,effectively reducing spinal curvature and enhancing pelvic symmetry.

Objectives:To investigate the clinical efficacy of Schroth scoliosis-specific exercises combined with three-dimensional traction therapy in spinal-pelvic remodeling for adolescents idiopathic scoliosis(AIS).Methods:80 AIS patients who received treatment at our hospital from June 2021 to June 2024 were en-rolled.They were randomly divided into a control group(n=40,received Schroth spinal scoliosis-specific cor-rection exercises alone)and a research group(n=40,underwent a combination of Schroth spinal scoliosis-spe-cific correction exercises and three-dimensional traction therapy)using a random number table method.The general demographic data of the two groups were well-balanced(P＞0.05).The clinical overall response rates of the two groups were compared,and spinal-pelvic remodeling indicators,including Cobb angle,angle of trunk inclination(ATI),angle of trunk rotation(ATR),C7 plumb line to the center sacral vertical line(C7-CSVL),api-cal vertebral translation(AVT),as well as median frequency(MF),mean power frequency(MPF),and average electromyography(AEMG)of the surface electromyography of the erector spinae muscles on the concave and convex sides,pelvic tilt(PT),pelvic incidence(PI),and sacral slope(SS),were assessed before treatment,at 1 month and 3 months after treatment.Repeated measures analysis of variance was conducted to test the main effects of spinal-pelvic remodeling indicators during the treatment period for both groups.Pearson correlation analysis was performed to examine the relationship between the Oswestry disability index(ODI)score and spinal-pelvic remodeling indicators.Results:The total effective treatment rate was significantly higher in the research group than in the control group(97.50％vs 67.50％,P＜0.001).Compared with the pre-treatment val-ues,the Cobb angle,ATI,and ATR of both groups decreased at 1 month and 3 months post-treatment(P＜0.05).Moreover,when compared with the control group,the research group showed a more pronounced de-crease in Cobb angle,ATI,and ATR at 1 month and 3 months post-treatment(P＜0.05).Both groups exhibited a decrease in PI and SS,along with an increase in PT at 1 month and 3 months post-treatment(P＜0.05).In comparison with the control group,the research group demonstrated a more significant decrease in PI and SS,and a more pronounced increase in PT at 1 month and 3 months post-treatment(P＜0.05).The C7-CSVL and AVT of both groups decreased at 1 month and 3 months post-treatment(P＜0.05),and the research group showed a more significant decrease in C7-CSVL and AVT compared with the control group at 1 month and 3 months post-treatment(P＜0.05).Both groups experienced an increase in MF,MPF,and AEMG of the sur-face electromyography of the erector spinae muscles at 1 month and 3 months post-treatment(P＜0.05),with the research group showing a more significant increase compared with the control group at 1 month and 3 months post-treatment(P＜0.05).The main effect tests revealed statistically significant time effects,inter-group effects,and interaction effects for the spinal-pelvic remodeling indicators during the treatment period(P＜0.05).The Cobb angle,ATI,ATR,C7-CSVL,AVT,MF,AEMG,MPF,PI,PT,and SS were all found to be corre-lated with the ODI score before and after treatment(P＜0.05).The decrease in the ODI score of study group after treatment was significantly better than that of control group(β=-6.178,P＜0.001).Conclusions:Schroth scoliosis-specific exercises combined with three-dimensional traction therapy significantly improve spinal-pelvic remodeling in AIS patients,effectively reducing spinal curvature and enhancing pelvic symmetry.

Objective:To explore the therapeutic efficacy and factors influencing the sequential combination of nucleos(t)ide analogues (NAs) with pegylated interferon alpha (Peg-IFN-α) in the treatment of patients with chronic hepatitis B (CHB).Methods:144 CHB cases with NAs treatment for more than 1 year, HBV DNA < 20 IU/ml, hepatitis B surface antigen (HBsAg) quantification < 3 000 IU/ml, treated with a sequential combination of Peg-IFN-α treatment for 48 to 96 weeks, and followed up were selected from the Fifth Medical Center of the PLA General Hospital between May 2018 and May 2020. Intention-to-treat analysis was used to measure the HBsAg clearance rate at 96 weeks. The Kaplan-Meier method was used to compute the cumulative HBsAg clearance rate at 96 weeks. Univariate and multivariate logistic regression were used to analyze the factors influencing HBsAg clearance at 48 weeks of sequential combination therapy. Univariate and multifactorial COX proportional hazard models were used to analyze the factors influencing HBsAg clearance following 96 weeks of prolonged PEG-IFN-α treatment. The receiver operating characteristic curve was used to assess the predictive value of factors influencing HBsAg clearance. A Mann-Whitney U test was used to compare the measurement data between groups. The count data was compared using the χ2 test between groups. Results:41 (28.47%) cases achieved HBsAg clearance at 48 weeks of sequential combination therapy. The HBsAg clearance rate at 96 weeks was 40.28% (58/144) by intention-to-treat analysis. The Kaplan-Meier method computed that the cumulative HBsAg clearance rate at 96 weeks was 68.90%. Multivariate logistic regression analysis showed that HBsAg quantification at baseline ( OR = 0.090, 95% CI: 0.034-0.240, P < 0.001) and a 24-week drop in HBsAg level ( OR = 7.788, 95% CI: 3.408-17.798, P < 0.001) were independent predictors of HBsAg clearance in CHB patients treated sequentially in combination with NAs and Peg-IFN-α for 48 weeks. Receiver operating characteristic curve analysis showed that the baseline HBsAg quantification [area under the receiver operating characteristic curve (AUC), 0.911, 95% CI: 0.852-0.952)] and 24-week drop in HBsAg level (AUC = 0.881, 95% CI: 0.814-0.930) had equally good predictive value for 48-week HBsAg clearance, but there was no statistically significant difference between the two ( Z = 0.638, P = 0.523). The value of the combination of baseline HBsAg quantification and 24-week drop in HBsAg level (AUC = 0.981, 95% CI: 0.941-0.997) was superior to that of single baseline HBsAg quantification ( Z = 3.017, P = 0.003) and 24-week drop in HBsAg level ( Z = 3.214, P = 0.001) in predicting HBsAg clearance rate at 48 weeks. Multivariate COX proportional hazards model analysis showed that HBsAg quantification at 48 weeks ( HR = 0.364, 95% CI: 0.176-0.752, P = 0.006) was an independent predictor of HBsAg clearance with a prolonged course to 96 weeks of Peg-IFN-α treatment. Conclusion:The HBsAg clearance rate can be accurately predicted with baseline HBsAg quantification combined with a 24-week drop in HBsAg level in patients with CHB who are treated with a sequential combination of NAs and Peg-IFN-α therapy for 48 weeks. Prolonging the course of Peg-IFN-α treatment can enhance the HBsAg clearance rate's capability. An independent predictor of HBsAg clearance is HBsAg quantification at 48 weeks of sequential combination therapy with a prolonged course of 96 weeks of Peg-IFN-α treatment.

In order to improve the students' interest and cultivate their scientific literacy, we tried to combine literature reading with the teaching material content of Experimental Nuclear Medicine. To complete literature interpretation, the students performed intensive reading and overall report, and the teacher made a final review and summary. The novel teaching method could improve the understanding of theoretical knowledge, deepen the recognition of experimental nuclear medicine technology, and expand the scientific view for the students, which are beneficial to cultivate the scientific literacy of the undergraduates.

The pandemic of Corona Virus Disease 2019 (COVID-19) continues, which shows the concentrated or sporadic cases in multiple places. Current COVID situation is still complex. During the COVID-19, routine diagnosis and treatment of liver cancer patients has been affected in different degrees. Under the premise of following the treatment guidelines, how to reduce the risk of infection of patients and medical staff, utilize limited medical resources to maximally ensure anti-tumor treatment and related emergency treatment, and help patients get through the epidemic period is a problem for liver oncologists. Thus, experts of liver cancer treatment related disciplines of Zhongshan Hospital, Fudan University have written the Expert guidance on overall management of liver cancer during the COVID-19, which aims to provide references for liver oncolo-gists to conduct clinical work safely and effectively under the epidemic prevention and control, and to help patients fight against the epidemic smoothly.

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

Objective: To evaluate the post-marketing safety profiles of the inactivated enterovirus type 71 (EV-A71) vaccine (Vero cell) after routine inoculation. Methods: Eleven cities of Zhejiang Province, Fengtai district of Beijing, Qinnan district, two counties as Pingle and Pingguo of Guangxi Zhuang Autonomous Region, and Dongtai city of Jiangsu Province were selected as the field sites. A total of 45 239 subjects were enrolled in this study from children who seeked the vaccination of EV-A71 vaccine during the period from July, 2016 to June, 2018. Different sampling method were adopted in different sites. All vaccinated children were invited to participate in the study in Fengtai and Dongtai, however, systematic sampling method were adopted in other sites. Active surveillance was conducted and information about adverse reactions (ARs) occurred in 30 min, 3 d and 30 d following each dose of EV-A71 immunization was collected by field observation, phone-call or face-to-face interview. The incidence of ARs in different types, symptoms and grades were described. Results: In total, there were 45 239 children who received 71 243 doses EV-A71 vaccine. The overall incidence of ARs was 1.079% (769 doses), with the highest incidence of 1.182% (177/14 973) in 5-11 month group and the lowest incidence of 0.849% (18/2 119) in ≥ 36 month group among different age groups. There was a higher incidence in solicited ARs, which was 1.047% (746 doses). The incidences of grade 1 and grade 2 ARs were also higher, which were 0.404% (288 doses) and 0.554% (395 doses), respectively. No grade 4 ARs occurred. The doses of the first and the second vaccination was 40 736 and 30 507, respectively, and the incidences of ARs were 1.281% (522 doses) and 0.810% (247 doses). Also, the incidences of ARs were 0.091% (37 doses) and 0.043% (13 doses) in local, and 1.168% (476 doses) and 0.760% (232 doses) in system. The symptoms of ARs after the two doses of vaccination were basically the same. Redness at the injection site was the most common local ARs after each dose vaccination, with doses of 24 and 11, while fever was the most common systemic ARs, with doses of 362 and 190. Moreover, ARs mainly occurred in 30 min to 3 d after each dose vaccination, with incidence of 1.016% (414 doses) and 0.698% (213 doses) in the first and second dose, respectively. Conclusion The ARs had a low incidence after vaccination in children and most were mild or moderate. EV-A71 vaccine with good safety is suitable for inoculation in a large scale.

Objective: This study aims to investigate the clinical effect of the improved extraction of low horizontally impacted mandibular third molars via a “three-section” method. Method: Sixty patients with low horizontally impacted mandibular third molars on both sides were selected for this study. A high-frequency electrotome, a 45 degree high-speed turbine and a special long drill needle were used in the test group. The improvement was called “three section”, which meant that the tooth was cut into three parts; first, the middle part was taken, then the root, and then the crown. One month later, the other side (control) was extracted using the regular method (the tooth was cut in two parts, and the crown was removed first). Operation time, swelling, pain, and limitations to mouth opening were carefully recorded and statistically analyzed. Results: The time for the modified “three-section” method, which was used to remove the third molar embedded in the lower part of the lower jaw, was (10.05 ± 0.51) min, while the mean time for conventional extraction was (20.15 ± 0.88) min, and the difference was statistically significant (P< 0.01). There were significant differences (P< 0.01) in swelling, pain and limitations to mouth opening between the test group and the control group. Conclusion he use of the “three-section” method to extract third molars horizontally embedded in the lower jaw is associated with a shorter operation time, reduced trauma and reduced postoperative reactions, and it has valuable clinical applications.

Objective To evaluate the effect of water improvement projects on drinking-water-borne endemic arsenism in Shanxi Province,to work out and refine sustainable prevention and control strategies.Methods The operating situation of water-improvement projects was investigated and monitored,and the arsenic content in drinking water was determined in drinking-water-borne arseniasis areas,which including 14 monitored sites in 5 countries from 2012 to 2017.The condition of arsenic poisoning in the resident population of the monitored sites was investigated and the arsenic content in the urine of patients was determined.Results Totally 14 monitored sites were already finished water improvement,the rate of water-improvement was 100％.Totally 11 water-improvement projects were monitored,including 7 small-scale water-improvement projects and 4 large-scale water-improvement projects,which all qualified and operated normally from 2012 to 2015.In 2016,one water-improvement project was found with excessive level (＞ 0.01 mg/L) of arsenic in drinking water in Shanyin County,and the other 10 water-improvement projects' arsenic contents were qualified.In 2017,two unqualified large-scale water-improvement projects had water arsenic content over (＞ 0.01 mg/L) in Shanyin County and Ying County,respectively.And the other 9 water-improvement projects were qualified.The detection rates of arsenic poisoning from 2012 to 2017 were 1.36％ (104/7 641),1.57％ (123/7 832),1.61％ (123/7 621),1.53％ (120/7 857),1.28％ (102/7 963) and 1.56％ (124/7 958),respectively,and the differences were not statistically significant (x2 =4.979 9,P ＞0.05).Most patients with arsenic poisoning were mild to moderate patients,accounted for 82.61％ (575/696) and no new case was detected.Conclusions Arsenic poisoning in drinking-water-borne arseniasis areas in Shanxi Province has been controlled.Natural operation of water-improvement projects has kept water arsenic levels normal.Water arsenic content has exceeded the standard in some of the water-improvement projects.The key point of next stage is strengthen the management of water improvement projects in prevention and treatment of drinking-water type endemic arsenism.