OBJECTIVE To explore the protective mechanism of amifostine on acute radiation injury mice. METHODS Thirty C57BL/6J mice were randomly divided into normal control group， model group and amifostine group （150 mg/kg）， with 10 mice in each group. Thirty minutes before irradiation， the mice in the amifostine group were intraperitoneally injected with amifostine； normal control group and model group were given constant volume of normal saline intraperitoneally； then acute radiation injury was induced by 4 Gy X-ray radiation in both model group and amifostine group. The white blood cell count （WBC）， platelet count and red blood cell （RBC） count in mice were detected 2 hours before irradiation and on days 1， 4， 7， 10 and 14 after irradiation； the changes in the proportion of WBC （neutrophils， lymphocytes and monocytes） on the 7th day after irradiation were analyzed. The 16S rRNA high-throughput sequencing was used to analyze the structure of gut microbiota in mice feces on the 7th day after irradiation， then its correlation with WBC was analyzed. RESULTS The counts of WBC on the 1st， 4th， 7th and 10th day after irradiation， platelet count on the 10th day after irradiation and RBC count on the 1st day after irradiation in the amifostine group were significantly higher than those in model group （P＜0.05）. Compared with normal control group，β diversity of gut microbiome showed significant change， relative abundance of Firmicutes increased and that of Bacteroidetes decreased in model group. Amifostine could reverse the change in β diversity of gut microbiome， and the relative abundance of Bacteroidetes and Firmicutes. The model group consisted of four distinct species， namely Allobaculum， Erysipelotrichia， Erysipelotrichales and Erysipelotrichaceae， which were significantly negatively correlated with the proportion of peripheral blood lymphocytes （P＜0.01）； amifostine group consisted of two distinct species， namely Lactobacillus murinus and L. crispatus， which were significantly negatively correlated with the proportion of neutrophils （P＜0.05）. CONCLUSIONS Amifostine significantly improves irradiation-induced injury by regulating dysbiosis of LY201816） gut microbiota.

[Objective] To analyze the influence of the cycle length of hepatitis B surface antigen (HBsAg) double reagent positive samples collected from voluntary blood donors in Guangzhou on the detection results. [Methods] A total of 127 044 blood samples from voluntary blood donors at Guangzhou Blood Center from August 10 to December 9, 2023 were selected. Two ELISA reagents were used for HBsAg detection, and samples with HBsAg double reagent positive and S/CO values<10 were tested continuously for 7 days to observe the changes in their S/CO values. [Results] A total of 505 HBsAg double reagent positive samples were detected, of which 52 had S/CO values less than 10. After 7 consecutive days of uninterrupted testing, the S/CO values of Wantai (median 5 decreased to 3) and Xinchuang (median 5 decreased to 3) showed an overall downward trend, and the HBsAg missed detection rate showed an upward trend (from 0 on the first day to 1/10 000 on the seventh day). A total of 13 cases had negative double reagent test results within the 7-day testing cycle. [Conclusion] With the extension of the detection cycle, the S/CO value of HBsAg detection shows a downward trend, and the missed detection rate of HBsAg shows an upward trend. Samples used for HBsAg detection should be tested promptly after sampling to improve the quality of blood testing.

Abstract Flood disasters are the common public health emergencies, mainly leading to environmental damage, water pollution, food pollution, vector breeding, infectious disease epidemic and other risk factors of sanitary and anti epidemic work. The guideline has been formulated with reference to the technical documents such as Guideline for Environmental Sanitation Disposal and Preventive Disinfection in Flooded Areas and Technical Proposal for Sanitary and Anti epidemic Measures after Flood Disasters, as well as the latest research progress at home and abroad. In order to guide the sanitary and anti epidemic measures in flooded areas, protect the health and safety of students and teachers and ensure the normal educational and teaching order, the guideline introduces the key measures that should be taken by schools, teachers and students in flood striken areas.

Objective:To analyze the improvement of patients with basilar invagination and atlantoaxial dislocation that treated by anterior or posterior surgery.Methods:50 patients with basilar invagination and atlantoaxial dislocation that underwent simple anterior or posterior surgery from 2009 to 2021 were included. There were 34 females and 16 males with a mean age of 45.04 years (range, 18-65 years). All patients underwent thin- slice CT scan of the neck. Preoperative and postoperative measurements of atlantoaxial joint distance, atlantoaxial joint angle, atlantoaxial joint displacement, Claus' Height, atlas-dens interval, space available for the cord, cervicomedullary angle, C 0-C 2 angle, and C 2-C 7 angle were measured. Then, the data were analyzed by independent sample t test. Results:25 patients (7 males, 18 females) were included in the anterior surgery group, and 25 patients (9 males, 16 females) were included in the posterior surgery group. The mean age of the two groups was 45.24±9.86 years and 44.72±14.06 years, respectively, showing no statistical difference. The mean last follow-up time of the anterior and posterior surgery group was 6.48±3.14 months and 7.04±2.87 months, respectively. The odontoid distance, atlas-dens interval, space available for the cord and cervicomedullary angle in 2 groups were significantly improved after surgery ( P<0.05), while there were no significant differences in the above parameters between 2 groups ( P>0.05). In the anterior surgery group, the distance and angle of atlantoaxial joint were increased, and the atlantoaxial joint displacement decreased significantly. While in the posterior surgery group, only the atlantoaxial joint space increased ( P<0.05). The C 0-C 2 angle was significantly increased and the C 2-C 7 angle was significantly decreased in the anterior surgery group ( P<0.05), but there was no significant difference in these parameters in the posterior surgery group ( P>0.05). In addition, there was no significant difference in parameters between the two groups at the last follow-up compared with those immediately after surgery. Conclusion:Both anterior and posterior surgery can improve the compression of the spinal cord in patients with basilar invagination and atlantoaxial dislocation. Anterior surgery may be more adequate for the extension and reduction of the atlantoaxial joint space, however, excessive enlargement of the lordosis angle in upper cervical may lead to the reduction of the lordosis in lower cervical.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective To indentify the cognitive status of Chinese patients to acne and the influencing factors to theirs' cognitive status,so as to provide solid evidences for the prevention and treatment of acne.Methods A self-designed questionnaire was made to conduct this survey of 16,156 acne patients,who seeked to the treatment in the dermatological departments from 112 hospitals in China.The survey consisted of several parts,including the general status of patients,the patients' cognition of occurrence,development and risk factors of acne,whether the first choice was seeking treatment at the hospital when the patients had acne and the condition of selection of skin care products.The factors were analyzed,which could impact the cognition of the patients' behavior of treatment,how did the patients' cognition to influence their medical behavior and skin care as well as the consistency of assessment of the severity of acne by doctors and patients themselves.Results The acne patients studied had the best knowledge of "acne is a skin disease","it not only occurs in the period of adolescence" and "the disease can be prevented and cured",which accordingly accounted for 80.65％,69.16％ and 65.49％ of the total patients respectively.However,the awareness of acne patients to heredity,high sugar and dairy products as risk factors for acne was insufficient,which accounted for 48.72％,42.40％ and 18.25％ of the total patients,respectively.Gender,age,educational level,occupation and health knowledge were the main factors affecting the cognitive level of patients;the survey also found that men,patient with educational level of junior high or even lower educational condition,occupation of labor workers or farmers and patients were lack of health education with poor knowledge of the genetics and dietary were risk factors for acne;patients with age over 36 years or with mild illness had poor knowledge of dietary risk factors for acne;the difference was statistically significant (P＜0.05).The analysis of the influence of cognitive status on medical treatment behavior and skin care showed that the better the cognition,the higher the probability of patients would choose medical treatment as the first choice as well as choosing functional skin care products;the difference was statistically significant (P＜0.05).The consistency of assessment of the severity of acne by doctors and patients was poor (Kappa value ＜0.4),and the assessment of severity of acne by patients was more serious than doctors' assessment.Conclusions Patient's cognitive status will affect their medical behavior and skin care,and there is also a phenomenon that patients have a more serious assessment of their acne condition.It is suggested that health education for acne patients should be strengthened in clinical medicine so as to improve their knowledge of acne as well as preventing from acne effectively.

Objective: To comprehensively evaluate the quality of Radix et Rhizoma Rhei based on gray correlationalanalysis and functional components, and to explore the difference of Radix et Rhizoma Rhei in different genuineproducing areas. Methods: HPLC was utilized to analyze 14 main compositions contained in the samples, includingemodin, rhein, chrysophanol, aloe-emodin, physcion, rheinoside, physcion glucoside, chrysophan, aloe-emodinglucoside, emodin methyl glycoside, sennoside, sennoside B, catechin and gallic acid. Then python 2.7 software wasemployed for gray correlation analysis of functional components closely related to the traditional efficacy of Radix et Rhizoma Rhei. Results: The qualities of Radix et Rhizoma Rhei grow in different areas were different. Tanggute Radix et Rhizoma Rhei grew in Tianzhu Gansu had the best effects of "expelling water retention and attacking the accumulation", and that grew in Yajiang Sichuan had the best effects of "clearing heat and removing toxin". Zhangye Radix et Rhizoma Rhei grew in Lixian Gansu had the best effect of"expelling stasis and unblocking the channels". Conclusion: Patternrecognition has broad prospects in the field of quality evaluation of traditional Chinese medicine. From the clinicalefficacy of traditional Chinese medicine, pattern recognition at the level of efficacy components can provide a new ideafor establishing a more complete and scientific quality evaluation system for traditional Chinese medicine.

Objective To investigate the current status of self-perceived burden and mindfulness of chronic obstructive pulmonary disease (COPD) patients and to explore the effect of mindfulness on patients' self-perceived burden. Methods From October 2016 to April 2017, a total of 276 patients with COPD were selected from a ClassⅢ Grade A hospital in Harbin by convenience sampling. The general information questionnaire, Five Facet Mindfulness Questionnaire (FFMQ), Self-Perceived Burden Scale (SPBS) were used to investigate the patients. Pearson correlation and multiple linear regression were used to analyze the effect of mindfulness on self-perceived burden. Results The score of self-perceived burden of COPD patients was (33.34±6.54) with a medium level. The score of mindfulness was (129.87±25.78). Pearson correlation showed the scores of dimensions and the total score of mindfulness except for the dimension of observation among COPD patients were negatively correlated with the self-perceived burden (P<0.05). Multiple linear regression revealed that three dimensions, mindfulness description, mindfulness action and no judging, entered the regression equation which were the influencing factors of self-perceived burden (P<0.05). Conclusions COPD patients commonly have self-perceived burden with different degrees which influenced by mindfulness. Health care providers could improve patients' mindfulness by reasonable intervention so as to reduce their self-perceived burden.

Objective To systematically review the efficacy and safety of Jinlian Qingre Effervescent Tablet (JQET) compared to Ribavirin for acute upper respiratory tract infection in children.Methods CNKJ,CBM,WanFang Data,VIP,PubMed,EM base,Web of science,and Cochrane Library databases were searched from the date of establishment to December 2016 for all randomized controlled trials (RCTs) and quasi-RCT on the use of JQET in children with acute respiratory infections.Meta-analysis by using Rev Man 5.3.Results A total of seven RCTs involving 782 patients were included,while the group of JQET involving 392 patients,Ribavirin involving 390 patients.The results ofmeta-analysis indicated that the efficacy in Jinlianqingre group was superior to that of Ribavirin control group,such as clinical effectiveness [RR=l.26,95％CI=(1.18,1.34),P＜0.000 01],fever subsidence time [MD=-1.54,95％CI (-1.79,-1.30),P＜0.000 01],the time of subsided cough [MD=-1.53,95％CI (-1.79,-1.27),P＜0.000 01],the disappearance time of pharyngalgia [MD=-1.29,95％CI (-1.88,-0.70),P＜0.000 1],and Pharyngeal congestion disappearance time [MD=-2.80,95％CI(-3.11,-2.49),P＜0.000 01].The difference was statistically significant.There were three adverse reactions reported in JQET group.Conclusion JQET is superior to the Ribavirin control group in clinical effectiveness,fever subsidence time,time of subsided cough,disappearance time of pharyngalgia,and pharyngeal congestion disappearance time to treat acute upper respiratory tract infection in children.However,these results should be carefully interpreted,and this conclusion has to be further verified by high quality,large scale RCTs.

Objective To explore the value of magnetic resonance imaging(MRI)in staging diagnosis of posterior fossa tumor in children. Methods The MRI features of low and high grade tumor for posterior fossa brain tumors confirmed by pathology in 19 children treated in Children's Hospital of Chongqing Medical University from January 2012 to December 2013 were retrospectively reviewed. The measurement of gross tumor volume, the ratio of solid component, the rate of brain edema and the tumor cystic degeneration rate were studied with statistical analysis, all datum were classified according to the World Health Organization (WHO) central nervous system tumor classification criteria. Results There were 5 cases in cerebellum and 4 cases in four ventricle in the low grade tumor group;there were 6 cases in four ventricle and 4 cases in cauda cerebelli in the high grade tumor group. Combined obstructive hydrocephalus: the low grade tumor group had 8 cases(8/9), the high grade tumor group had 10 cases (10/10). The gross tumor volume: (51.2±3.2) mm3for the low grade tumor group, (31.9±1.8) mm3for the high tumor group, there was significantly statistical difference (t= 2.591, P = 0.019). The ratio of solid components: 41.7 % for the low grade tumor group, 66.1 % for the high tumor group, there was also significantly statistical difference (χ 2= 6.52, P < 0.05). Combined the edema around brain parenchyma: the low grade tumor group had 4 cases(4/9), the high grade tumor group had 4 cases (4/10), there was no statistical difference (χ2= 2.591, P = 0.274). The tumor cystic degeneration: the low grade tumor group had 9 cases (9/9), the high grade tumor group had 4 cases (4/10), there was no statistical difference (χ2= 0.052, P = 0.819). Conclusions MRI has high clinical application values in staging diagnosis of posterior fossa brain tumor in children. It can provide the basis for clinical operation plan.