Objective To comprehensively evaluate the current situation of traditional Chinese medicine resource allocation in grassroots community health service centers in Guangzhou in 2022.Methods Based on the index system of traditional Chinese medicine resource allocation(community health service center)in Guangzhou,MATLAB R2021a and SPSS 27 software were used to comprehensively evaluate the current situation of traditional Chinese medicine resource allocation in 116 community health service centers in Guangzhou by TOPSIS method and RSR method.Results The allocation of TCM resources in 5 communities,including Xiaoguwei Street Community Health Service Center in Panyu District,Guangzhou City,Dadong Street Community Health Service Center in Yuexiu District,Guangzhou City,Fengyuan Street Community Health Service Center in Leiwan District,Guangzhou City,was evaluated as"excellent",and the allocation of TCM resources in 4 communities was rated as"poor".In addition,27,53 and 27 community health service centers were rated as"upper middle","medium"and"lower middle"respectively.Analysis of variance showed that the difference was statistically significant(F = 231.268,P<0.001).Conclusion TOPSIS method combined with RSR method can better evaluate the allocation of TCM resources in grass-roots communities:The allocation of TCM resources in grass-roots communities in Guangzhou is generally good,but there are still significant differences among different communities.In the future,health administrative departments at all levels in Guangzhou can rationally allocate resources according to the differences of different com-munities and better improve the capacity building of traditional Chinese medicine service in grassroots communities.

Two pediatric heart failure patients were treated with pulmonary artery banding(PAB)at Fuwai Hospital,from December 2021 to January 2022.In the first case,an 8-month-old patient presented with left ventricular non-compaction cardiomyopathy(LVNC),left ventricular systolic dysfunction,ventricular septal defect,and atrial septal defect.The second case was a 4-month-old patient with LVNC,left ventricular systolic dysfunction,and coarctation of the aorta.After PAB,the left ventricular function and shape of both patients were significantly improved,without serious surgery-related complications.In these individual cases of pediatric heart failure,pulmonary artery banding exhibited a more satisfactory efficacy and safety compared to pharmacological treatment,especially for those with unsatisfactory medication results.Future clinical data are needed to promote the rational and broader application of this therapeutic option for indicated patients.

Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Objective:To explore the optimal keV value of the virtual monoenergetic image (VMI) for displaying the osteosarcoma by using the dual-layer spectral detector CT and to evaluate its application value in determining the extent of intramedullary invasion of osteosarcoma.Methods:From August 2021 to August 2022, 57 patients with conventional osteosarcoma of long bone confirmed by biopsy in Beijing Jishuitan Hospital, Capital Medical University were retrospectively analyzed. All patients completed dual-layer spectral CT enhanced examination before limb salvage surgery, and tumor segment resection specimens were obtained after surgery. Conventional 120 kVp image and VMI of 40, 50, 60, 70 and 80 keV were obtained by spectral CT examination, and the CT values of tumors, image noise were measured and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the corresponding images were calculated. The objective evaluation among the six groups of images were assessed with the Friedman test, and then determined the optimal keV value. The maximum distance between the intramedullary boundary of osteosarcoma and the adjacent articular surfaces was measured on the best keV VMI and the tumor segment resection specimens. The Wilcoxon signed rank test was used to find the differences and the Spearman correlation analysis was used to evaluate the correlation between the distance measured from the best keV VMI and the specimens.Results:There were significant differences in CT value, image noise, SNR and CNR between 40-80 keV VMI and 120 kVp conventional CT images ( P<0.05). The CT value, SNR and CNR of 40 and 50 keV VMI were better than 120 kVp ( P<0.001). The 50 keV VMI was chosen as the best keV VMI to measure the intramedullary extent of osteosarcoma. The distance measured from 50 keV VMI was 103.9 (80.4, 131.4) mm, while the distance measured from specimens was 113.5 (94.0, 142.0) mm, and the difference was statistically significant ( Z=-5.76, P<0.001). The 50 keV VMI measurements in 51 patients were smaller than the gross specimens, which underestimated the tumor intramedullary extent, with the difference was 11.1 (6.6, 13.8) mm. The Spearman correlation analysis demonstrated a high positive correlation of distance measured on gross specimens with the 50 keV VMI ( r s=0.960, P<0.001). Conclusions:Dual-layer spectral detector CT with 50 keV VMI is the best image to show the limb osteosarcoma. Compared with gross specimens, the distance measured from CT underestimated the intramedullary invasion range of limb osteosarcoma about 10 mm, but the two show a good correlation.

Objective:To evaluate the effect of circLPAR3 on the radiosensitivity of esophageal cancer cells and investigate its mechanism.Methods:The cancer tissues and and adjacent tissues of 37 patients with esophageal cancer were collected, and esophageal cancer cell lines Eca-109, EC9706 and KYSE30 and esophageal epithelial cells HET-1A were cultured in vitro. The expression levels of circLPAR3 and miR-1238 in the tissues and cells were measured by RT-qPCR. Eca-109 cells were transfected with circLPAR3 siRNA and miR-1238 mimics or co-transfected with circLPAR3 siRNA and miR-1238 inhibitor. Cell cloning experiment was conducted to evaluate the effects of silencing circLPAR3, overexpressing miR-1238, or silencing both circLPAR3 and miR-1238 on the radiosensitivity of Eca-109 cells. After Eca-109 cells that silenced circLPAR3, overexpressed miR-1238 or silenced both circLPAR3 and miR-1238 were exposed to 4 Gy irradiation, CCK-8 assay (A value), flow cytometry and Western blot were employed to assess the effects of silencing circLPAR3, overexpressing miR-1238, or silencing both circLPAR3 and miR-1238 combined with 4 Gy irradiation on the proliferation and apoptosis of Eca-109 cells and the expression levels of CyclinD1, p21, Bcl-2 and Bax proteins. Dual luciferase reporter gene experiment and RNA pull down experiment were performed to verify the regulatory relationship between circLPAR3 and miR-1238. Results:Compared with adjacent tissues, the expression level of circLPAR3 was up-regulated in the esophageal cancer tissues ( P<0.05), while that of miR-1238 was down-regulated ( P<0.05). Compared with HET-1A cells, the expression levels of circLPAR3 were up-regulated in the esophageal cancer cell lines Eca-109, EC9706 and KYSE30(all P<0.05), whereas those of miR-1238 were down-regulated (all P<0.05). Silencing circLPAR3 or overexpressing miR-1238 reduced the survival fraction of Eca-109 cells (all P<0.05), and the sensitization ratio was 1.21 and 1.75, respectively. Silencing circLPAR3 or overexpressing miR-1238 decreased the A value of Eca-109 cells and the expression levels of CyclinD1 and Bcl-2 proteins (all P<0.05), while increased the apoptosis rate of Eca-109 cells and the expression levels of p21 and Bax proteins (all P<0.05). After silencing circLPAR3 or overexpressing miR-1238 combined with 4 Gy irradiation, the A value of Eca-109 cells and the expression levels of CyclinD1 and Bcl-2 proteins were decreased (all P<0.05), while Eca-109 cell apoptosis rate and the expression levels of p21 and Bax proteins were increased (all P<0.05). circLPAR3 targeted and negatively regulated the expression level of miR-1238 in Eca-109 cells. After silencing miR-1238 and circLPAR3 simultaneously, the survival fraction of Eca-109 cells was higher than that when only silencing circLPAR3, and the sensitization ratio was 0.59. Silencing miR-1238 reversed the effects of silencing circLPAR3 combined with 4 Gy irradiation on the proliferation and apoptosis of Eca-109 cells. Conclusion:circLPAR3 is highly expressed in esophageal cancer tissues and cell lines, and silencing the expression of circLPAR3 can inhibit the proliferation of esophageal cancer Eca-109 cells, promote their apoptosis, and enhance cell radiosensitivity by up-regulating miR-1238.

Objective:To examine whether the mixed infection rate in pertussis infants is significantly higher than that in non-pertussis infants with respiratory tract infection, to explore the mixed infection pathogen distribution in pertussis infants, and to provide reference for clinical diagnosis and treatment.Methods:A case-control study was conducted on 118 nasopharyngeal swabs collected from infants who applied for clinical pertussis etiological testing (culture and specific nucleic acid detection of Bordetella pertussis) in Beijing Children′s Hospital, Jiaxing Maternity and Child Health Care Hospital and Wuhu No.1 People′s Hospital from August 2018 to January 2021.According to the pertussis etiological testing results, the patients were divided into the pertussis group (65 cases) and non-pertussis group (53 cases). Thirty-three pairs of cases were matched according to age, onset season and city.All nasopharyngeal swabs were tested for infections of other pathogens using FilmArray RP2, which can detect 21 respiratory infection pathogens.The mixed infection rate was compared between groups by Chi- square test. Results:According to the FilmArray RP2 test results, 56.9%(37/65) cases in pertussis group and 15.1%(8/53) cases in the non-pertussis group were positive for multiple pathogens, and the difference was statistically significant ( χ2=21.651, P<0.001). The top 5 mixed infection pathogens in pertussis infants were human rhinovirus/enterovirus (HRV/EV) (38.5%, 25/65), parainfluenza virus (PIV) (18.5%, 12/65), respiratory syncytial virus (RSV) (10.8%, 7/65), coronavirus (Cov) (10.8%, 7/65), and adenovirus (ADV) (7.7%, 5/65). The mixed infection rates of the pertussis group in spring, summer, autumn and winter were 46.2% (6/13), 58.3%(14/24), 55.6%(5/9), and 63.2%(12/19), respectively.Comparison of matched and unmatched cases achieved similar results. Conclusions:Among clinical suspected pertussis infant specimens, the mixed infection rate in confirmed cases is tremendously higher than that in non-pertussis infants.The main mixed infection pathogens in pertussis infants are HRV/EV, PIV, RSV, Cov, and ADV.Mixed infection in pertussis children commonly occurs in four seasons, with the highest incidence in winter.

Objective:To investigate the effect of circ-PRKDC on lung cancer cell proliferation, apoptosis and radiosensitivity and its molecular mechanism.Methods:Normal lung epithelial cells BEAS-2B and lung cancer cell lines NCI-H1299, NCI-H2170, NCI-H1975 were cultured. NCI-H1299 cells were divided into the si-NC, si-PRKDC, pcDNA-NC, pcDNA-PRKDC, miR-NC, miR-505-3p, anti-miR-NC, anti-miR-505-3p, si-PRKDC+ anti-miR-NC and si-PRKDC+ anti-miR-505-3p groups. RT-qPCR was used to detect the expression levels of circ-PRKDC and miR-505-3p. Western blot was employed to measure the protein expression. MTT was used to detect cell proliferation. Flow cytometry was utilized to detect cell apoptosis. Plate clone formation assay was conducted to detect the cell radiosensitivity. Dual luciferase reporter assay was performed to analyze the targeting relationship between circ-PRKDC and miR-505-3p.Results:Compared with normal lung epithelial cells BEAS-2B, the expression levels of circ-PRKDC in the lung cancer cell lines NCI-H1299, NCI-H2170 and NCI-H1975 were significantly up-regulated (3.65, 3.10, 2.67 vs. 1.00, all P<0.05), whereas those of miR-505-3p were significantly down-regulated (0.42, 0.50, 0.54 vs. 1.02, all P<0.05). After low expression of circ-PRKDC, the expression level of CyclinD1 was significantly down-regulated (0.42 vs. 0.81, P<0.05), whereas those of Cleaved-caspase-3(0.71 vs. 0.33, P<0.05) and γ-H 2AX (0.89 vs. 0.46, P<0.05) were significantly up-regulated, the cell A value was significantly decreased (0.413 vs. 0.839, P<0.05), cell apoptosis rate was significantly increased (20.35 vs. 6.21, P<0.05), cell survival fraction was significantly decreased ( P<0.05), and β-catenin expression was significantly down-regulated (0.35 vs. 0.73, P<0.05). After high expression of miR-505-3p, the expression level of CyclinD1 was significantly down-regulated (0.34 vs. 0.83, P<0.05), those of Cleaved-caspase-3(0.65 vs. 0.32, P<0.05) and γ-H 2AX (0.96 vs. 0.45, P<0.05) were significantly up-regulated, the cell A value was significantly decreased (0.386 vs. 0.851, P<0.05), the apoptosis rate was significantly increased (16.38 vs. 6.20, P<0.05), and the cell survival fraction was significantly decreased ( P<0.05). Compared with miR-NC, the luciferase activity of miR-505-3p group transfected with circ-PRKDC wild-type reporter plasmid was significantly decreased (0.44 vs. 1.00, P<0.05). Down-regulation of miR-505-3p could reverse the effect of low expression of circ-PRKDC on the proliferation, apoptosis, radiosensitivity and β-catenin expression of NCI-H1299 cells. Conclusion:Low expression of circ-PRKDC may inhibit lung cancer cell proliferation, promote cell apoptosis and enhance cell radiosensitivity by up-regulating miR-505-3p, which is probably associated with the Wnt/β-catenin signaling pathway.

Aiming at the continuous advancement and deepening of curriculum ideological and political education in medical courses, taking the recent outbreak of public health emergency as an example, this paper expounds the feasibility of taking public health emergencies as typical cases of ideological and political education in public health courses in medical colleges from medical ethics, national spirit, policy guidelines, medical and health administrative system, social benefits and economic evaluation, scientific research collaboration, international cooperation and other aspects, in order to realize the simultaneous development of professional education and ideological and political education, and cultivate more high-quality medical talents with both merit and talent.

The correlation between transient receptor potential vanilloid-1 (TRPV1) receptor and peripheral nervous system diseases has been confirmed. In recent years, studies have shown that TRPV1 plays an important role in the central nervous system; its wide distribution in the hippocampus, cortex, and midbrain bridges the correlation between TRPV1 receptor and cognitive learning and memorial function. This paper reviews the biological role of TRPV1 receptor in the nervous system at home and abroad and concludes the relations of TRPV1 receptor with cognitive associated diseases, aiming at providing theory basis for whether TRPV1 receptors can be used as therapeutic drug targets for cognitive associated diseases.

Objective:To observe the effect of different temperature rewarming on intraoperative brain protection in children with deep hypothermia circulatory arrest (DHCA).Methods:Totally 24 cases of children undergoing deep hypothermia circulatory arrest under general anesthesia were selected, and randomly divided into 38 ℃ and 43 ℃ groups including 12 cases respectely. Children patients in each group were given forced air rewarming at 38 ℃ and 43 ℃ respectively during the rewarming phase after cross-clamping remission. The age of patients, weight, operation time, intraoperative blood loss, intraoperative fluid infusion and postoperative length of stay were recorded. The arterial blood was taken to determine the serum neuron-specific enolase (NSE) , Platelet activating factor (PAF), and blood lactic acid immediately when the patients were entering into operating room (T 0), before Extracorporeal Circulation (T 1), before aortic cross-clamping (T 2), before DHCA (T 3), rewarming (T 4), temperature to 30 ℃ (T 5), temperature to 33 ℃ (T 6), temperature to 35 ℃ (T 7), CPB was terminated (T 8) and at the end of operation (T 9). And the body temperature were recorded at T 0, T 1, T 3 and T 8. Results:At T 0, T 1, T 3, T 8 and T 9, the temperature difference between the two groups was not statistically significant ( P>0.05). The body temperature first decreased and then increased in the group of 38℃ and 43℃ ( P<0.01). And the serum PAF and NSE significantly increased during the operation ( F values were 5 172.087, 3 535.935, P<0.01). The content of PAF, NSE and lactate in 38 ℃ group and 43 ℃ group increased with time from T 0 to T 9 ( P<0.01).The PAF content of children in the 43℃ group at T 8 and T 9 were (20.34±4.70) μg/L and (25.46±7.75) μg/L respectively, lower than that in the 38℃ group (25.20±3.80) μg/L and (34.97±8.52) μg/L, the differences were statistically significant ( F value was 7.769, P=0.011; F value was 8.193, P=0.009). At T 8 and T 9, NSE content of children in the 43℃ group were (22.13±5.13) μg/L and (28.15±7.90) μg/L respectively, lower than those in the 38℃ group (26.92±3.89) μg/L and (36.57±8.90) μg/L, the differences were statistically significant ( F value was 6.656, P=0.017; F value was 6.012, P=0.023). Blood lactic acid content of children in the 43℃ group at T 4-T 9 respectively (2.77±0.70), (2.93±0.69), (3.13±0.77), (3.39±0.64), (3.77±0.86), (3.83±0.62) mmol/L, lower than 38 ℃ group of children (3.57±0.87), (3.82±0.80), (4.35±0.89), (4.60±0.95), (4.79±0.94), (4.92±0.92) mmol/L, the differences were statistically significant ( F values were 6.125-11.551, P values were 0.022-0.003). Conclusion:Both 38 ℃ and 43 ℃ can ensure that the body temperature of the children increases steadily during the intraoperative rewarming phase in deep hypothermic circulatory arrest operation,but 43℃ can effectively reduce the serum PAF and NSE in children with brain protection, its mechanism may be associated with reduced blood lactic acid.