Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

The emerging and re-emerging arthropod-borne infectious diseases pose a serious threat to global public health security. Field and laboratory studies of arthropods of medical importance are essential and critical for the prevention and control of arthropod-borne infectious diseases. Various institutions or universities in China have been conducting research in the field or laboratory study of arthropods of medical importance, but up to 2023, it is still lacking detailed biosafety guidelines or recommendations that can guide the related work for arthropods of medical importance. In order to proactively address potential biosafety issues in the field or laboratory activities related to arthropods of medical importance, improve the standardization of arthropod biosafety classification, operations, and protection, and ensure the safety of practitioners, an expert consensus on the biosafety recommendation of arthropods of medical importance in field and laboratory has been developed, aiming to guide the future work of arthropods and ensure the national biosafety and biosecurity of China.

ObjectiveTo confirm the clinical efficacy and safety of Yishen Yangxin Anshen tablets in the treatment of insomnia （heart-blood deficiency and kidney-essence insufficiency syndrome）. MethodA randomized block， double-blind， placebo-controlled， multi-center clinical trial design method was adopted， and a total of 480 patients with insomnia due to deficiency of heart blood and insufficiency of kidney essence （treatment group-control group 3∶1） from seven hospitals （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， The First Clinical Hospital， Jilin Province Academy of Traditional Chinese Medicine（TCM）， The Second Affiliated Hospital of Liaoning University of TCM， The First Affiliated Hospital of Henan University of Chinese Medicine， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine） were enrolled. The treatment group was given Yishen Yangxin Anshen tablets and the control group received placebo tablets （4 tablets/time， 3 times/day， 4 weeks of administration， 4 weeks of follow-up after drug withdrawal）. The sleep dysfunction rating scale （SDRS） score， pittsburgh sleep quality index （PSQI） score， TCM， polysomnography （PSG） indicators from four hospital （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine）， and other efficacy indicators were compared between the two groups before and after treatment. Through general physical examination， laboratory examination， and observation of adverse events， the safety of the drugs was evaluated. ResultThe baseline indexes of the two groups showed no significant difference and thus the two groups were comparable. After treatment， the total score of SDRS in the treatment group was lower than that in the control group （P<0.01）. After drug withdrawal for 4 weeks， the total score of SDRS demonstrated no significant change in the treatment group as compared with that at the end of treatment， indicating that the rebound change of curative effect was not obvious. After treatment， the total score of PSQI in the treatment group decreased as compared with that in the control group （P<0.01）， and the change of total score of PSQI in the treatment group was statistically significant （P<0.05） after drug withdrawal for 4 weeks but small， indicating that the rebound change of curative effect was not obvious. After treatment， the total effective rate about the TCM symptoms in the treatment group was higher than that in the control group （χ²=137.521，P<0.01）. After treatment， the disappearance rates of single indexes in the treatment group， such as difficulty in falling asleep， easily waking up after sleeping， early awakening， short sleep time， dreamfulness， palpitation， forgetfulness， dizziness， mental fatigue， and weakness of waist and knee， increased compared with those in the control group （P<0.01）. After treatment， the treatment group demonstrated fewer awaking times （AT）， longer total sleep time （TST）， lower ATA/TST ratio， and higher sleep efficiency （%） than the control group （P<0.05）. No abnormal value or aggravation related to drugs was observed in either group. The incidence of adverse events in the treatment group and the control group was 5.57% and 8.40% respectively. No serious adverse events or adverse events leading to withdrawal happened in either group. ConclusionYishen Yangxin Anshen tablets is effective and safe for patients with insomnia of deficiency of heart-blood and insufficiency of kidney-essence.

Aspergillosis ; Humans ; Mucor ; Mucormycosis/drug therapy*

Objective:To provide a scientific basis for reducing the rate of invalid ambulance attendance and the establishment of grades dispatch system through a retrospective analysis of the invalid ambulance attendance in prehospital emergency care.Methods:The data of the invalid ambulance attendance was collected in Huazhong University of Science and Technology Union Shenzhen Hospital (the only tertiary hospital of in Nanshan District) from 2014 to 2018, and the reasons of the invalid ambulance attendance, the time period during the invalid ambulance attendance occurred (every 3 hours was divided into one time period), and the reasons of ambulance calling were statistically analyzed.Results:① The invalid ambulance attendance rates showed a fluctuating decrease trend year by year from 2014 to 2018, the rates were 31.22% (2 515/8 055), 26.94% (2 147/7 970), 29.80% (2 398/8 046), 25.69% (1 844/7 177) and 21.89% (1 686/7 703), respectively. The total invalid ambulance attendance rate was 27.19% (10 590/38 951) in the five years. ② The top three reasons for the invalid ambulance attendance were cancelled calls, departure before the ambulance arrived, and going to hospital by themselves, accounting for 36.87%, 25.08%, and 17.03%, respectively. The constituent ratios of the causes of invalid ambulance attendance in each year were different with statistical significance (χ 2 = 217.626, P < 0.001). ③ The top three time period of invalid ambulance attendance occurred at 21:00-23:59, 18:00-20:59 and 09:00-11:59, accounting for 16.86%, 14.95% and 13.54%, respectively. There was no statistical significance in the distribution of time period in each year (χ 2 = 32.571, P = 0.252). ④ The top five reasons for ambulance calling of invalid ambulance attendance were fainting/syncope, trauma, alcoholism, traffic accident injuries, and brawls, accounting for 20.13%, 15.67%, 9.97%, 8.64%, and 6.45%, respectively, and there was statistically significant difference in the distribution of the reason for ambulance calls in each year (χ 2 = 194.213, P < 0.001). Conclusion:The invalid ambulance attendance rate is high in Nanshan District of Shenzhen. Improving the professional level and triage ability of the dispatchers, improving the system construction of prehospital emergency care system and increasing social education are conducive to reduce invalid ambulance attendance rate.

OBJECTIVE: This study was performed to evaluate the accuracy and reliability of a newly designed method to achieve mandibular dental model superimposition, using voxel-based cone-beam computed tomography (CBCT) registration. METHODS: Fourteen dry cadaveric mandibles and six teeth extracted from patients with severe periodontitis were used to establish 14 orthodontic tooth-movement models. The protocol consisted of two steps: in the first step, voxel-based CBCT mandible superimposition was performed; the reference comprised the external portion of the symphysis, extending to the first molar. The laser-scanned dental model image was then integrated with the CBCT image to achieve mandibular dental model superimposition. The entire process required approximately 10 minutes. Six landmarks were assigned to the teeth to measure tooth displacement, using tooth displacement on the superimposed laser-scanned mandibles as the reference standard. Accuracy was evaluated by comparing differences in tooth displacement based on the method and the reference standard. Two observers performed superimposition to evaluate reliability. RESULTS: For three-dimensional tooth displacements, the differences between the method and the reference standard were not significant in the molar, premolar, or incisor groups (p > 0.05). The intraclass correlation coefficients for the inter- and intra-observer reliabilities of all measurements were > 0.92. CONCLUSIONS Our method of mandibular dental model superimposition based on voxel registration is accurate, reliable, and can be performed within a reasonable period of time in vitro, demonstrating a potential for use in orthodontic patients.

Tooth decay is prevalent, and secondary caries causes restoration failures, both of which are related to demineralization. There is an urgent need to develop new therapeutic materials with remineralization functions. This article represents the first review on the cutting edge research of poly(amido amine) (PAMAM) in combination with nanoparticles of amorphous calcium phosphate (NACP). PAMAM was excellent nucleation template, and could absorb calcium (Ca) and phosphate (P) ions via its functional groups to activate remineralization. NACP composite and adhesive showed acid-neutralization and Ca and P ion release capabilities. PAMAM+NACP together showed synergistic effects and produced triple benefits: excellent nucleation templates, superior acid-neutralization, and ions release. Therefore, the PAMAM+NACP strategy possessed much greater remineralization capacity than using PAMAM or NACP alone. PAMAM+NACP achieved dentin remineralization even in an acidic solution without any initial Ca and P ions. Besides, the long-term remineralization capability of PAMAM+NACP was established. After prolonged fluid challenge, the immersed PAMAM with the recharged NACP still induced effective dentin mineral regeneration. Furthermore, the hardness of pre-demineralized dentin was increased back to that of healthy dentin, indicating a complete remineralization. Therefore, the novel PAMAM+NACP approach is promising to provide long-term therapeutic effects including tooth remineralization, hardness increase, and caries-inhibition capabilities.
Amines ; pharmacology ; Calcium ; Calcium Phosphates ; chemistry ; pharmacology ; Dentin ; chemistry ; Humans ; Nanocomposites ; chemistry ; Nanoparticles ; Tooth Remineralization ; methods

Objective To analyze the clinical features and definitive repair strategies of bile duct strictures after hepatectomy.Methods The clinical data of patients undergoing definite repair for bile duct strictures after hepatectomy in the PLA General Hospital from 2000 to 2014 and Beijing Tsinghua Changgung Hospital from 2014 to 2017 were retrospectively collected.Results Twenty-one patients with bile duct stricture after hepatectomy were treated with reoperation.Among them,13 cases showed continuous bile leakage after operation.The types of hepatectomy include 10 cases of left or extended left hemihepatectomy,7 cases of right or extended right hemihepatectomy,2 cases of mesohepatectomy,and 2 cases of hepatic caudate labectomy.According to classification formulated by the Biliary Surgery Group of Chinese Medical Association,the types of injuries of the patients included four of Ⅱ 2,twelve of Ⅱ 3,and five of Ⅱ 4 respectively.19 of 21 patients underwent definitive repair with hepaticojejunostomy.The long-term follow-up success rate was 89.0％.Conclusions Biliary injury after hepatectomy in which the injury affects the secondary or below hepatic ducts requires surgical repair.Hepaticjejunostomy is an effective definitive repair method.Hepaticjejunostomy for bile duct stenosis after right hemihepatectomy always need to dissect the left intrahepatic bile duct by a hilar plate approach or UPV approach,due to the effect of hepatic portal transposition.Surgical repair for bile duct stenosis after the left hepatectomy,always need the incision of the right anterior and right posterior hepatic duct,due to extensive injuries of hepatic duct.

Objective To evaluate the effect of dexmedetomidine on the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.Methods Forty-two patients of either sex with intracranial aneurysm,aged 57-78 yr,weighing 53-86 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective balloon occlusion test of the internal carotid artery under general anesthesia,were assigned into 2 groups (n =21 each) using a random number table:propofol conbined with remifentanil group (group PR) and dexmedetomidine combined with propofol and remifentanil group (group DPR).In group DPR,dexmedetomidine was intravenously infused over 15 min in a loading dose of 0.5 μg · kg-1 before induction of anesthesia,followed by an infusion of 0.3 μg · kg-1 · h-1 throughout surgery.Propofol and remifentanil were given by target-controlled infusion (TCI) after infusion of the loading dose.The patients were mechanically ventilated after placement of the laryngeal mask airway.Maintenance of anesthesia was as follows:propofol and remifentanil were given by TCI with the target plasma concentrations of 0.5-1.0 μg/ml and 1-3 ng/ml,respectively,in group DPR;propofol and remifentanil were given by TCI with the target plasma concentrations of 3-5 μg/ml and 3-6 ng/ml,respectively,in group PR.Bispectral index (BIS) value was maintained at 40-60.Before wakeup test,propofol infusion was stopped and the target plasma concentration of remifentanil was decreased to 0.5 ng/ml in two groups,and the infusion rate of dexmedetomidine was decreased to 0.1 pg · kg-1 · h-1 in group DPR.The wake-up time was recorded and the wake-up quality was assessed.After admission to the operating room (T0,baseline),at 10 min before wake-up test (T1),immediately after patients were wakened (T2),at 10 min after patients were wakened (T3) and at the end of wake-up test (T4),the mean blood pressure (MAP),heart rate,respiratory rate (RR),SpO2 and BIS values were recorded.The development of intraoperative awareness,emergence time,postoperative agitation,nausea and vomiting,regurgitation and aspiration and severe pain was recorded.Results MAP,heart rate,SpO2 and RR were all within the normal range during wake-up period in two groups.Compared with the baseline at To,MAP was significantly decreased at Ti,3,4 in group PR,and BIS value was decreased at T1-4 in DPR and PR groups (P＜0.05).Compared with group PR,MAP was significantly increased at T1.3,BIS value was decreased at T24,the wake-up time was shortened,Ramsay sedation score and wake-up quality were increased,the emergence time was shortened,and the incidence of agitation was deceased (P＜0.05),and no significant change was found in verbal rating scale scores assessed after extubation in group DPR (P ＞ 0.05).No cardiovascular events,respiratory depression,intraoperative awareness,postoperative nausea and voniting,regurgitation and aspiration or severe pain was found in two groups.Conclusion Dexmedetomidine can raise the quality of intraoperative wake-up test in the patients undergoing balloon occlusion test of the internal carotid artery.