Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.
Acetylation ; Animals ; Cold-Shock Response ; Epigenesis, Genetic ; Macrophages/metabolism* ; Mice ; Mitochondria/metabolism*

Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.

Objective To examine the effect of the inter-stimulus interval (ISI) in magnetic stimulation (MS) on astrocyte migration and its related mechanism.Methods Cultured astrocytes were treated with intermittent MS with intervals of 1,5 and 10 seconds.The PEA-15 inhibitor BisI (10 μmol/ml) and the ERK1/2 inhibitor U0126 (10 μmol/ml) were administered and cell migration assays evaluated the astrocytes' migration.The expression of phosphorylated ERK1/2 and PEA-15 was detected using Western blotting.Results The 1 second interval significantly facilitated astrocyte migration,the phosphorylation of PEA-15 and ERK1/2,and the expression of MMP-9 (browse matrix metalloproteinase-9).The addition of Bis I significantly reduced the production of phosphorylated ERK1/2 and MMP-9,as well as astrocyte migration induced by MS.In addition,pretreatment with U0126 also significantly decreased the astrocyte migration induced by MS.Conclusion 1s-ISI MS can induce PEA-15 activation and subsequently lead to ERK1/2 phosphorylation and upregulation of MMP-9,which may contribute to the migration of astrocytes.

[Objective] By means of study of related literature records about Neiguan points in Great Compendium of Acupuncture and Moxibustion, it is intended to provide a theoretical foundation for the application of Neiguan points in modern clinical acupuncture and moxibustion. [Method] Collect articles with regard to Neiguan points inGreat Compendium of Acupuncture and Moxibustion , and systematically analyze its location, needling and moxibustion techniques, as well as clinical application law. To investigate the clinical application of differences between ancient and modern Neiguan. [Results] InGreat Compendium of Acupuncture and Moxibustion, Neiguan points are located at 2-inch above palm strips. Needle can be penetrated into 3/10 inch, 1/2 inch, and 1.2inch between two tendons. Neiguan point is a collateral-connecting acupoint for pericardium meridian, and mainly treats cardiothoracic excess and deficiency related diseases. If matching with yangchi point, it can be called Yuan-primary point and collateral-connecting point combination that can treat triple energizer meridian related diseases. The Neiguan point is also regarded as the eight confluence point connecting Yinwei meridian that can treat mental diseases, Yinwei vessel is associated three yin meridians of foot diseases, conception vessel diseases and Yangming Channel penetration diseases. [Conclusion] It is concluded the location, needling therapy and clinical application law of Neiguan points in Great Compendium of Acupuncture and Moxibustion, which is of reference significance to the application of Neiguan points in modern clinical acupuncture and moxibustion.

Objective To examine the molecular mechanism involved in astrocyte migration induced by magnetic stimulation (MS),and the role of high mobility group box 1 (HMGB1) in migration.Methods Astrocytes were isolated from the cortical tissues of 2-3 day old Sprague-Dawley rats and divided into a stimulus group given MS and a control group without MS.The stimulus group was further divided into an experimental group and a control group,with the former pre-stimulated with 10 μmol/ml U0126 for 30 minutes and no pre-stimulation for the latter.The cells in the experimental group were also randomly divided into siRNA and HMGB1-siRNA transfection groups to examine the role of HMGB1 in astrocyte migration induced by MS.The SiRNA group was transfected with HMGB1 siRNA.Western blotting was used to detect any effect of MS on HMGB1 and extracellular signal-regulated kinase1/2 (ERK1/2).The migration of astrocytes was detected using the scratch assay.Results MS (10 Hz) can promote the phosphorylation of ERK,increase the migration of astrocytes and the expression of HMGB1.After the U0126 treatment and transfection with HMGB1 siRNA,the effects of MS on expression of HMGB1 and migration of astrocytes decreased significantly.Conclusions Magnetic stimulation-mediated migration of astrocytes via activation of the ERK pathway phosphorylation and autocrine of HMGB1.

Aim To determine the effective compo-nents of Semen Ziziphi Spinosae for sedative-hypnotic and its mechanism. Methods The extraction of Se-men Ziziphi Spinosae and the rat brain homogenates were prepared. High concentrations of Diazepam com-petitively replaced the ligand compounds of Semen Ziz-iphi Spinosae combining BDZ receptor in brain tissue, and all the compounds with sedative and hypnotic effects were collected and identified by HPLC and LC-MS technique, as the compounds extracted from the brain tissue were administered with Semen Ziziphi Spi-nosae. The brain tissue was administered with Diaze-pam, and with Semen Ziziphi Spinosae and Diazepam. Results The HPLC chromatograms show that the peak time of BDZ receptor ligand compounds was 2. 71 min and 46. 87min, when compared with Diazepam. And the LC-MS chromatograms display the relative molecu-lar weight of the ligand compounds was 274. 28 m/z, 453. 34 m/z,496. 34 m/z and 608. 38 m/z respective-ly. According to the fingerprint of Semen Ziziphi Spi-nosae, these compounds may be fatty acid substances and lupine pill triterpene compounds. Conclusions On the basis of the principle of receptor ligand bind-ing, we established a way to quickly analyze and iden-tify the role of natural products in the same drug target compounds. The method not only can clearly define the effective components of natural products, but also clar-ify the mechanism of action of the compounds. The ac-tive ingredient of calm hypnosis in Semen Ziziphi Spi-nosae may be fatty acid substances Palmitic acid ( C16 H32 O2 ) and lupine pill triterpene compounds Alphitolic acid( C30 H48 O4 ) and Spinosin( C28 H32 O15 ) . They exert their sedative and hypnotic effects by combining with BDZ receptor, and the research has laid a theoretical foundation for the further study about mechanism of Se-men Ziziphi Spinosae.

Objective To observe the surface electromyographic characteristics of the bilateral submen-tal muscles in dysphagia secondary to unilateral brainstem stroke. Methods A total of 25 subjects were recrui-ted. There were 8 stroke patients with dysphagia secondary to a left brainstem stroke and 7 stroke patients with dysphagia secondary to a right brainstem stroke. There were also 10 healthy controls matched in age and gender. The duration and peak amplitude of the submental muscle when swallowing 5 ml of warm water were recorded u-sing a surface electromyograph. Results The average amplitude of the left submental muscle in patients with a left brainstem stroke was significantly longer than that of those with a right brainstem stroke, but no significant differences in average duration were observed. Conversely, the amplitude of the right submental muscle in pa-tients with a right brainstem stroke was significantly longer than that of those with left brainstem stroke, but again there were no significant differences in duration. No significant differences were observed among the healthy con-trols. The amplitude and duration of both the affected and healthy sides of the patients were of course significantly longer or stronger than those of the healthy controls. Conclusion The swallowing function of the bilateral sub-mental muscles may be impaired among unilateral stroke survivors with dysphagia. The damage on the affected side is more severe than on the opposite side.

Objective To investigate iodine nutritional status of pregnant women of Taizhou City,in order to provide a basis for assessment whether normal consumption of iodized salt is needed,to take complement iodine measure and to carry out monitoring of urinary iodine and thyroid function in pregnant women.Methods Early pregnancy (gestation ＜ 4 months),medium (4 to 7 months gestation) and late (pregnancy≥8 months) of each of more than 300 pregnant women were chosen from maternal and child health (hospital) and part of the township hospitals of Taizhou City (district) from September 2012 to December 2013.Based on the principle of informed consent,disposable urine and blood samples were collected,urine iodine and thyroid hormone [serum thyroid stimulating hormone (TSH),three free triiodothyronine (FT3) and free thyroid hormone (FT4)] were measured.Urinary iodine was measured using a urinary iodine rapid quantitative detection kit,thyroid function was measured by an electrochemical method.Use 95％ of the reference value range of thyroid function in pregnant women as the basis for evaluation of thyroid function in pregnant women.Results A total of 997 pregnant women were investigated,early stage,medium-term and late pregnancy women were 302,357 and 338,respectively.The median urinary iodine was 124,129,119 μg/L,pregnant women in late pregnancy had the lowest iodine urine.The median TSH of early stage,medium-term and late pregnancy women were 2.03,2.18,2.22 mU/L;the mean FT3 and FT4 of the three groups were (4.39 ± 0.66),(4.06 ± 0.61),(3.92 ± 0.61)pmol/L and (14.56 ± 2.56),(13.08 ± 2.03),(12.70 ± 2.38)pmol/L,respectively.The rate of abnormal thyroid function was 4.91％ (49/977),mainly in subhypothyroidism [48.98％ (24/49)].Conclusions Poor iodine-nutritional status exists in some pregnant women in Taizhou City.It is necessary to strengthen the propaganda and education of pregnant women on iodine supplement knowledge in the future,and carry out routine monitoring of urinary iodine and thyroid function in early pregnancy.