Objective　To detect clustered regularly interspaced short palindromic repeats (CRISPR) in Listeria monocytogenes, and analyze the structure and homology of CRISPR loci. Methods Totally 34 strains of Listeria monocytogenes isolated in our laboratory were identified, PCR amplified and sequenced. The repeat sequence structure and spacer sequence homology in CRISPR loci were analyzed by bioinformatics software. Results A total of 7 CRISPR loci were detected in 34 strains. The mutation rate of the first 2 and last 2 bases of the Repeat sequence of CRISPR loci was higher, while the mutation rate of the middle part was lower. Seven CRISPR sites form eight CRISPR structural types, among which the Repeat sequences of CRISPR1 and CRISPR2 are relatively conserved, while the Repeat sequences of CRISPR1 and CRISPR5 can form dumbbell shaped secondary structures. The number of Spacer sequences contained in each CRISPR site ranges from 2 to 15, with an average of 2.43. The 136 Spacer sequences detected were not only homologous to Listeria plasmids and bacteriophages, but also homologous to uncultured virus sequences, staphylococcal bacteriophages, and Listeria innocua. The same CRISPR genotype did not show large-scale clustering, but some strains in the same year were in the same evolutionary cluster with close genetic relationships. Conclusion The CRISPR structure of Listeria monocytogenes in this study exhibits high specificity, and its homology with bacteriophages provides a theoretical basis for the application of bacteriophages in the control and prevention of Listeria monocytogenes.

Objective:To investigate the feasibility of construction of rat models of psoriasis-like lesions by using interleukin (IL) -23/T-helper 17 (Th17) axis-related cytokines combined with imiquimod.Methods:A total of 110 Wistar rats were randomly divided into normal control group, imiquimod alone group, imiquimod combined with interferon (IFN) -α2a (180 000, 60 000, 20 000 IU/kg) groups, imiquimod combined with tumor necrosis factor (TNF) -α (45 000, 15 000, 5 000 IU/kg) groups, and imiquimod combined with IL-2 (90 000, 30 000, 10 000 IU/kg) groups, and there were 10 rats in each group. After hair removal from the central area (2 cm × 2 cm) of the rat back, rats in the imiquimod alone group were topically treated with imiquimod 5% cream at a dose of 20 mg/cm 2 on the shaved back; rats in the imiquimod combined with different cytokine groups were treated with topical imiquimod 5% cream at the same dose on the shaved back for 15 minutes followed by intraperitoneal injections of cytokines at corresponding doses once a day for 10 consecutive days. During the treatment, skin lesions on the rat back were evaluated by using the psoriasis area and severity index (PASI) scores every day. On day 10, serum samples were collected from the rats after anesthesia, and enzyme-linked immunosorbent assay (ELISA) was performed to detect levels of IL-17A, TNF-α, IL-23, IFN-α and IL-1β in the serum samples in each group; then, the rats were sacrificed, lesional skin tissues on the rat back were taken for histopathological examinations and evaluated by Baker scores; an immunohistochemical study was conducted to determine the expression of CD4 and CD8 in some skin lesions. One-way analysis of variance was used for comparisons among multiple groups, and least significant difference (LSD) - t test for multiple comparisons; for data with heterogeneous variance, the Kruskal-Wallis H test was used. Results:On day 3 after molding, the rats in the imiquimod alone group and combination groups gradually presented with psoriasis-like skin manifestations, such as erythema, scales and epidermal thickening; the PASI scores reached a peak on day 7 in the imiquimod alone group, and on day 6 in the combination groups. On day 10, histopathological examination of the skin lesions in the imiquimod alone group and combination groups both showed different psoriasis-like pathological features, such as hyperkeratosis, parakeratosis, acanthosis, thinning or disappearance of the granular layer. There were significant differences in the PASI scores and Baker scores among the normal control group, imiquimod alone group and combination groups ( H = 43.33, F = 42.15, both P < 0.001). The PASI scores were higher in the imiquimod combined with IFN-α2a (180 000 IU/kg) group and the imiquimod combined with IL-2 (90 000 IU/kg) group (9.4 ± 1.1, 8.8 ± 0.6, respectively) than in the imiquimod alone group (7.5 ± 1.1, P = 0.002, 0.030 respectively) ; the Baker scores were higher in the imiquimod combined with IFN-α2a (180 000, 60 000 IU/kg) groups, the imiquimod combined with TNF-α (45 000 IU/kg) group, and the imiquimod combined with IL-2 (90 000 IU/kg) group than in the imiquimod alone group (all P < 0.05). The serum levels of TNF-α, IL-17A, IL-1 β and IL-23 significantly differed among groups ( F = 128.97, F = 6.90, H = 27.45, H = 21.10, all P < 0.05). Compared with the imiquimod alone group, the IL-17A level significantly increased in the imiquimod combined with IL-2 (30 000 IU/kg) group (5.54 ± 1.78 pg/ml vs. 4.20 ± 1.14 pg/ml, P = 0.009), and the IL-23 level significantly increased in the imiquimod combined with IL-2 (90 000 IU/kg) group (37.89 ± 32.85 pg/ml vs. 8.56 ± 6.08 pg/ml, P = 0.036). Immunohistochemical study showed significant differences in the expression of CD4 and CD8 in skin lesions among all groups ( F = 7.21, H = 18.32, both P < 0.001), and the expression of CD4 and CD8 in skin lesions was significantly higher in the imiquimod combined with IL-2 (90 000 IU/kg) group than in the imiquimod alone group ( t = -2.46, -2.32, respectively, both P < 0.05) . Conclusion:Imiquimod combined with IFN-α2a or IL-2 could promote the occurrence of psoriasis-like skin lesions in rats, aggravate the development of psoriasis and prolong the maintenance time of the rat models.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective:To explore the effect of fully automatic image segmentation of adenoid and nasopharyngeal airway by deep learning model based on U-Net network. Methods:From March 2021 to March 2022, 240 children underwent cone beam computed tomography（CBCT） in the Department of Otolaryngology, Head and Neck Surgery, General Hospital of Shenzhen University. 52 of them were selected for manual labeling of nasopharynx airway and adenoid, and then were trained and verified by the deep learning model. After applying the model to the remaining data, compare the differences between conventional two-dimensional indicators and deep learning three-dimensional indicators in 240 datasets. Results:For the 52 cases of modeling and training data sets, there was no significant difference between the prediction results of deep learning and the manual labeling results of doctors（P>0.05）. The model evaluation index of nasopharyngeal airway volume: Mean Intersection over Union（MIOU） s （86.32±0.54）%; Dice Similarity Coefficient（DSC）: （92.91±0.23）%; Accuracy: （95.92±0.25）%; Precision: （91.93±0.14）%; and the model evaluation index of Adenoid volume: MIOU: （86.28±0.61）%; DSC: （92.88±0.17）%; Accuracy: （95.90±0.29）%; Precision: （92.30±0.23）%. There was a positive correlation between the two-dimensional index A/N and the three-dimensional index AV/（AV+NAV） in 240 children of different age groups（P<0.05）, and the correlation coefficient of 9-13 years old was 0.74. Conclusion:The deep learning model based on U-Net network has a good effect on the automatic image segmentation of adenoid and nasopharynx airway, and has high application value. The model has a certain generalization ability.
Child ; Humans ; Adolescent ; Adenoids/diagnostic imaging* ; Image Processing, Computer-Assisted/methods* ; Pharynx ; Cone-Beam Computed Tomography ; Nose

Objective : To investigate the changes of iron and other metal elements and inflammatory factor γ interferon (IFN⁃γ) in the liver after taking deferiprone (DFP) in mice with chronic infection of Toxoplasma gondii , and to investigate the efficacy of DFP in the treatment of liver injury caused by chronic infection of Toxoplasma gondii. Methods : 6 ⁃week⁃old female C57BL/6 mice were randomly divided into four groups : control group , control + DFP group , TgCtWh6 group , TgCtWh6 + DFP group , with 6 mice in each group , and sterile gavage PBS in control group. Daily gavage was 50 μg/kg DFP in TgCtWh6 + DFP group , 20 toxoplasma cysts in TgCtWh6 group , 20 toxoplasmosis cysts in TgCtWh6 + DFP group , 20 toxoplasmosis cysts with daily gavage of 50 μg/kg DFP , and mice were sacrificed and liver tissues were taken after 45 days. Inductively coupled plasma mass spectrometry (ICP⁃MS) was used to detect the content of iron and other metal elements in mouse liver tissues. Real⁃time PCR (qRT⁃PCR) and Western blot were used to detect the mRNA levels and protein levels of IFN⁃γ and ferritin heavy chain (Fth) in mouse liver tissues , respectively. Results : Compared with the TgCtWh6 group , the Fth content in the liver (P < 0. 01) was significantly reduced in the liver of the TgCtWh6 + DFP group after taking DFP , the iron metabolism disorder was effectively improved , the IFN⁃γ content in the liver was significantly lowered (P < 0. 01) , and the inflammatory response of the liver was also reduced. Conclusion DFP can effectively improve iron metabolism disorders in the liver after infection with Toxoplasma gondii and reduce inflammatory damage in the liver.

Objective:To analyze the changes of hospitalization rates in different regions, medical institutions and populations in China from 2009 to 2019, so as to provide reference for the country to make relevant decisions.Methods:The data of China′s health statistical yearbook from 2009 to 2019 were obtained, and the changes of hospitalization rate and the number of hospitalizations per 100 outpatient and emergency admissions in different regions and medical institutions, and hospitalization rate of different populations and different diseases were analyzed. Descriptive analysis and frequency analysis were used.Results:The hospitalization rate in China continued to rise, from 9.95% in 2009 to 19.03% in 2019. Among them, the hospitalization rate in the eastern, central and western regions increased from 9.7%, 9.9% and 10.8% to 17.0%, 19.3% and 21.5% respectively, with an average annual growth rate of 5.8%, 6.9% and 7.1% respectively. The number of inpatients in public hospitals increased by 1.2 times and that in private hospitals increased by 4.5 times. The number of inpatients in tertiary, secondary and primary hospitals and primary medical institutions increased by 292.9%, 80.8%, 166.4% and 4.5% respectively.From 2009 to 2018, the number of hospitalizations per 100 outpatient and emergency admissions in the hospital increased from 4.5 to 5.7, and decreased to 5.6 in 2019. The increase of hospitalization rate of urban residents was less than that of rural residents. The hospitalization rate of residents aged 0-4 and ≥55 years increased the fastest. In recent years, the discharge diseases were mainly common diseases, chronic diseases and frequently occurring diseases, including pneumonia, acute upper respiratory tract infection, diabetes, and hypertension.Conclusions:During the ten years of medical reform, the hospitalization rate in China has continued to rise, and the overall trend is reasonable. There are significant differences in the changes of hospitalization rates between urban and rural areas, regions and populations in China.

Hydrogen sulfide (H

Objective:To explore effects of specialist nurse sharing of Respiratory Medicine Department in transitional care of patients with chronic obstructive pulmonary disease (COPD) under medical integration mode.Methods:Using the convenient sampling method, a total of 134 COPD patients who were hospitalized in Respiratory Department of Xinxiang Central Hospital were selected from October 2018 to October 2019. They were randomly divided into the control group and the observation group, with 67 cases in each group. The patients in the control group were given routine management after they were discharged from the hospital, while patients in the observation group were given specialist nurse sharing of Respiratory Medicine Department under medical integration mode for a period of 1 year after they were discharged from the hospital. BODE index, COPD Assessment Test (CAT) scale score, readmission rate and average length of hospital stay within 1 year were compared between the two groups.Results:After intervention, percent predicted of forced expiratory volume in first second (FEV1% Predicted) and Six-Minute Walk Test (6MWT) in the observation group were higher than those in the control group and higher than those before the intervention, and the differences were statistically significant ( P<0.05) . After the intervention, mMRC score, BODE index and CAT score of the observation group were lower than those of the control group and were lower than those before the intervention, and the differences were statistically significant ( P<0.05) . The readmission rate within 1 year of the observation group and the control group were respectively 23.88% and 49.25%, and the difference between the two groups was statistically significant ( P<0.05) . The average length of hospital stay within a year in the observation group was shorter than that in the control group, and the difference between the two groups was statistically significant ( P<0.05) . Conclusions:Transitional care for COPD patients using specialist nurse sharing of Respiratory Medicine Department under medical integration mode can effectively alleviate the condition, improve quality of life, reduce the readmission rate and shorten the average length of hospital stay.

Objective To investigate the potential risk factors for mild cognitive impairment (MCI) in the elderly population in the community, and to provide a basis for the primary prevention of MCI. Methods A cross-sectional study of elderly population in communities of Shanghai, China was conducted. A total of 368 subjects including both males and females, aged 65-80 years old, were selected to complete the mini-mental state examination (MMSE), basic information questionnaires, and physical examinations. Logistic regression analysis was used to analyze the potential risk factors of MCI. Results Of the 368 subjects participating in the study, 53 were found to have MCI and the prevalence rate was 14.4%. Univariate analysis found that older age, low education, no folic acid supplementation, stroke, osteoporosis and hyperlipidemia were risk factors of MCI. Multiple logistic regression analysis showed that advanced age [OR=1.146 (95%CI: 1.052-1.249)] and osteoporosis [OR=2.371 (95%CI: 1.042-5.396)] were the independent risk factors for MCI, while higher education [OR=0.073 (95%CI: 0.011-0.478)] was a protective factor. Age influenced all the aspects of MMSE scores (all P values <0.05). In addition, the analysis of the results suggested that subjects with regular folic acid supplementation got higher MMSE scores, especially in the aspect of language and praxis (P=0.002). On the contrary, patients with osteoporosis had lower attention and computing power scores (P=0.022). Conclusion The prevalence of MCI increased with age. Low education and osteoporosis may be the independent risk factors for MCI in the elderly population. Although no association was observed between folic acid supplementation and MCI, folic acid supplementation could improve the performance of language and praxis.

Objective:To investigate the characteristics of ischemic myocardial contracture after asphyxia-induced cardiac arrest (CA).Methods:Asphyxia and ventricular fibrillation (VF) induced cardiac arrest model was established. Thirty-one male Wistar rats were randomly(random number) assigned to the sham, asphyxia and VF groups. Electrocardiogram and blood pressure during CA stage were recorded. Arterial blood was drawn for blood gas analysis at 0 min after CA. The length and width of the heart were measured at 0,2,4,6 and 8 min after CA. The myocardial ATP contents were measured at 0 and 8 min after CA.Results:Compared with the VF group, the time of CA induction was longer in the asphyxia group[ (237±20 ) s vs (3±1) s, P<0.05]. At 0 min after CA, severe hypoxemia, carbon dioxide retention and acidosis had occurred in the asphyxia group, while these indexes in the VF group were basically normal. The length and width of the heart in the asphyxia group decreased gradually after CA, the myocardial contracture reached the limit around 6 min after CA, while the cardiac morphology of the VF group did not change significantly during the observation period of 8 min after CA. Myocardial ATP content in the asphyxia group decreased significantly at 0 min after CA ( P<0.05), while the difference between the VF group and the sham group was not statistically significant ( P>0.05). Conclusions:Myocardial contracture occurrs in the early stage of asphyxia CA, which may be related to ATP consumption in the asphyxia stage.