BACKGROUND:Ankylosing spondylitis is a chronic inflammatory disease with chronic rheumatic immunity.Soft tissue ossification and fusion and spinal stiffness can cause biomechanical changes. OBJECTIVE:To reconstruct the lumbar-sacral intervertebral disc in ankylosing spondylitis patients with lumbar kyphosis by finite element analysis,and to study the range of motion of each segment of T11-S1 and the biomechanical characteristics of annulus fibrosus and nucleus pulposus. METHODS:The imaging data were obtained from an ankylosing spondylitis patient with lumbar kyphosis.The original CT image data of continuously scanned spine were imported into Mimics 21.0 in DICOM format,and T11-S1 was reconstructed respectively.The established model was imported into 3-Matic software in the format of"Stl"to reconstruct the intervertebral disc,and the fibrous intervertebral disc model was obtained.The improved model was further imported into Hypermesh software,and the vertebra,nucleus pulposus,annulus fibrosus and ligament were mesh-divided.After the material properties were given,the model was imported into ABAQUS software to observe the range of motion of each vertebral body in seven different working conditions of T11-S1,and analyze the biomechanical characteristics of each segment of annulus fibrosus and nucleus pulposus. RESULTS AND CONCLUSION:(1)The range of motion of L1 vertebrae was higher than that of other vertebrae under six different working conditions:extension,forward flexion,rotation(left and right),and lateral flexion(left and right).The maximum range of motion was 2.18° during L1 vertebral flexion,and the minimum range of motion was 0.12° during L5 vertebral extension.(2)The annular fiber flexion at L2-L3 segments was greater than the extension(P<0.05),and the annular fiber flexion at L3-L4 and L4-L5 segments was less than the extension(P<0.05).The left rotation of L1-L2 annular fibers was greater than the right rotation(P<0.05).The left flexion of the annulus was greater than the right flexion in L1-L2,L2-L3,L3-L4,L4-L5 and L5-S1 segments(P<0.05).(3)The nucleus pulposus stresses of T11-L12,L1-L2,L2-L3,L3-L4 and L4-L5 segments in forward flexion were greater than in extension(P<0.05).The left rotation of T12-L1 and L3-L4 segments was smaller than the right rotation(P<0.05),and that of T11-T12,L1-L2,and L2-L3 segments was larger than the right rotation(P<0.05).The left flexion was larger than the right flexion in the T11-S1 segment.(4)It is concluded that in ankylosing spondylitis patients with lumbar kyphosis,the minimum range of motion of the vertebral body is located at the L5 vertebral body in extension.To prevent fractures,it is recommended to avoid exercise in the extension position.During the onset of lumbar kyphosis in patients with ankylosing spondylitis,the maximum stress of the annulus fibrosus and nucleus pulposus is located in the L1-L2 segment,which is fixed and will not alter with the change of body position.The late surgical treatment and correction of deformity should focus on releasing the pressure of the annulus fibrosus and nucleus pulposus in this segment to avoid the rupture of the annulus fibrosus and the injury of the nucleus pulposus.

Objective: To construct an evaluation index system to assess the response capacity of universities to public health emergencies, so as to provide a basis for improvements the response capacity. Methods: In November 2019, in order to develop an evaluation system based on literature review and expert discussions, 15 experts were invited to conduct a subjective evaluation used hierarchical analysis. The objective evaluation was conducted in 120 universities in Jiangsu Province used the inverse entropy weighting method, and the final evaluation employed the joint subjective and objective weighting method. Results: The indicator system consisted of four primary indicators, nine secondary indicators, 32 tertiary indicators and 67 quaternary indicators. The analysis of the combined weighting method showed that the primary indicators, in descending order, included incident handling capability ( 0.666 ), incident detection capability (0.203), prior preparation capability (0.101) and post event recovery capability ( 0.031 ). The top three secondary indicator weights were emergency response (0.480), monitoring and reporting (0.203) and command and coordination (0.151). The results of the evaluation of the consistency indicators showed that the expert authority coefficient was 0.909 and the Kendall s W coordination coefficient was 0.836 ( P <0.01), with all consistency scale values < 0.1. Conclusion The evaluation system is highly scientific and credible, and provides basis for evaluating the response capability of universities to public health emergencies.

In order to screen African swine fever virus (ASFV) diagnostic antigen with the best enzyme linked immunosorbent assay (ELISA) reactivity. By establishing the ELISA method, the diagnostic antigen of ASFV p30 protein expressed by baculovirus-insect cell expression system as reference, we explored the antigenic properties and diagnostic potential of ASFV p35 protein expressed by prokaryotic expression system as a diagnostic antigen. The results of Western blotting and immunofluorescence show that the molecular weight of the recombinant p35 protein and p30 protein obtained was 40 kDa and 30 kDa, respectively, and these two proteins had good immuno-reactivity with ASFV positive serum. Recombinant p30 and p35 proteins were used as diagnostic antigens to establish ELISA, and the sensitivity and repeatability of these methods were tested. The results show that although the detection sensitivity of the p30-ELISA established in this study was higher than that of the p35-ELISA, the sensitivity of p35-ELISA was 95.8%, and variations in intra- and inter-assay repeatability of the two methods were less than 10%. The coincidence rate between the p35-ELISA and the imported kit was 97.2%. Results show that p35-ELISA was sensitive and stable, and could detect specific antibodies against ASFV.
African Swine Fever/diagnosis* ; African Swine Fever Virus/genetics* ; Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Recombinant Proteins/genetics* ; Swine

Objective:Based on systematic idea of clustering methods, a novel approach for classifying prescriptions was explored in the light of the method of classifying analogous prescriptions.Methods:A total of 581 ancient prescriptions were selected from Treatment Record of Hundreds of Selected Ancient Prescriptions, and the standardized names of Traditional Chinese Medicines in these prescriptions were entered in Microsoft Excel 2007, then imported to SPSS 24.0 to generate dendrograms using the hierarchical clustering function. The classification of 581 selected ancient prescriptions was analyzed. Results:All 581 prescriptions could be classified into 86 categories through repeated clustering, the largest group has 29 prescriptions, the smallest group has 2 prescriptions, and the average group has about 6.75 prescriptions. In general, the later the intercepted group, the lower the similarity of its internal prescriptions.Conclusion:This method could realize the classification of prescriptions in the light of the method of classifying analogous prescriptions, which may help to break the original thinking bondage and further deepen the understanding of compatibility rules of prescriptions. However, its disadvantage lied in that the theoretical clues would be reduced when analyzing the compatibility rules of prescriptions and the issues of drug dosage, nature, taste and meridian categories were not specially considered.

Objective:To explore the clinical effect of "information knowledge belief practice" model, namely "IKAP theory" nursing intervention model on patients with peritoneal dialysis(PD).Methods:The clinical data of 120 patients with PD treated in The Second Hospital of Tianjin Medical University from January 2020 to December 2020 were analyzed retrospectively. The patients were randomly divided into control group and observation group, with 60 cases in each group. In the observation group, there were 32 males and 28 females with an age range of (56.16±10.25) years, including 18 cases of diabetic nephropathy, 22 cases of chronic glomerulonephritis and 20 cases of hypertensive nephropathy. In the control group, there were 34 males and 26 females, with an age range of (56.27±10.34) years, including 14 cases of diabetic nephropathy, 18 cases of chronic glomerulonephritis and 28 cases of hypertensive nephropathy. The patients in the control group were given routine nursing. In addition to the routine nursing, the patients in the observation group also adopted IKAP mode for nursing intervention. The levels of hemoglobin (HB), serum albumin (ALB), comprehensive nutrition assessment score (SGA) and nursing satisfaction of the two groups were compared before and 6 months after the intervention. The comparison of measurement data before and after intervention in the intervention group was analyzed by paired sample t-test. Frequency data were compared and analyzed by Chi-square ( χ2) test. Results:Before the intervention, there was no significant difference in ALB, Hb levels and SGA between the observation group and the control group( t=1.001~1.743, all P>0.05). After the intervention, the SGA score of the observation group was lower than that of the control group, while the levels of ALB and Hb were higher than those of the control group, and the differences between the two groups were statistically significant ( t=3.411~5.050, all P<0.05). The satisfaction of patients in the observation group was 95%, while that in the control group was 78.33%, and the difference between the two groups was statistically significant ( χ2=7.212, P<0.05). Conclusions:For peritoneal dialysis patients, IKAP nursing intervention can not only effectively improve their nutritional status, but also increase their satisfaction with nursing. IKAP nursing intervention model is worthy of clinical promotion.

Objectives: Fitting and forecasting the trend of COVID-19 epidemics. Methods: Based on SEIR dynamic model, considering the COVID-19 transmission mechanism, infection spectrum and prevention and control procedures, we developed SEIR^{+ CAQ} dynamic model to fit the frequencies of laboratory confirmed cases obtained from the government official websites. The data from January 20, 2020 to February 7, 2020 were used to fit the model, while the left data between February 8-12 were used to evaluate the quality of forecasting. Results: According to the cumulative number of confirmed cases between January 29 to February 7, the fitting bias of SEIR^{+ CAQ} model for overall China (except for cases of Hubei province), Hubei province (except for cases of Wuhan city) and Wuhan city was less than 5%. For the data of subsequent 5 days between February 8 to 12, which were not included in the model fitting, the prediction biases were less than 10%. Regardless of the cases diagnosed by clinical examines, the numbers of daily emerging cases of China (Hubei province not included), Hubei Province (Wuhan city not included) and Wuhan city reached the peak in the early February. Under the current strength of prevention and control, the total number of laboratory- confirmed cases in overall China will reach 80 417 till February 29, 2020, respectively. Conclusions The proposed SEIR^{+ CAQ} dynamic model fits and forecasts the trend of novel coronavirus pneumonia well and provides evidence for decision making.

Objectives:The COVID-19 epidemic has swept all over the world. Estimates of its case fatality rate were influenced by the existing confirmed cases and the time distribution of onset to death, and the conclusions were still unclear. This study was aimed to estimate the age-specific case fatality rate of COVID-19.Methods:Data on COVID-19 epidemic were collected from the National Health Commission and China CDC. The Gamma distribution was used to fit the time from onset to death. The Markov Chain Monte Carlo simulation was used to estimate age-specific case fatality rate.Results:The median time from onset to death of COVID-19 was M=13.77 ( P25- P75: 9.03-21.02) d. The overall case fatality rate of COVID-19 was 4.1 % (95 %CI: 3.7 %-4.4 %) and the age-specific case fatality rate were 0.1 %, 0.4 %, 0.4 %, 0.4 %,0.8 %, 2.3 %, 6.4 %, 14.0 and 25.8 % for 0-, 10-, 20-, 30-, 40-, 50-, 60-, 70- and ≥80 years group, respectively. Conclusions:The Markov Chain Monte Carlo simulation method adjusting censored is suitable for case fatality rate estimation during the epidemic of a new infectious disease. Early identification of the COVID-19 case fatality rate is helpful to the prevention and control of the epidemic.

Objective To systematically evaluate the efficacy and safety of 125I seed implantation on the treatment of refractory thyroid carcinoma.Methods A total of 14 patients with refractory thyroid carcinoma received CT and ultrasound image-guided 125I seed implantation in our hospital from Apr.2003 to Oct.2016.The radioactive activity ranged from 0.3 to 0.8 mCi,and the prescribed doses were 80 to 120 Gy.11 patients were diagnosed as differentiated thyroid carcinoma and 3 patients were medullary thyroid carcinoma.The local control rate,pain relief and complications were observed.Results The patients were followed up from 12 to 96 months.Two months after treatment,complete remission happened in three patients,partial remission in nine,and disease stability in two,no patients with progression.The half year,one year,two year local control rate was 100％,92％ and 42％,respectively.Seven patients were evaluated using number rating scales and obtained a score of 4.14±1.68 before therapy.Two months after treatment,the score was reduced to 2.00±1.15 (P＜0.000).No usual complications occurred during or after treatment except for I acute skin radio reaction in 4 cases.Conclusion 125I seed interstitial implantation for refractory thyroid carcinoma under guidance of ultrasound or CT is efficient and safe.

Objective To investigate the value of stretched-exponential model of DWI in differential diagnosis of benign and malignant breast lesions.Methods Totally 58 patients with 63 breast lesions (33 benign,30 malignant lesions) were enrolled.All the patients underwent multiple b value DWI and dynamic contrast enhancement MRI (DCE-MRI) scans.The values of ADC,DDC and water molecular diffusion heterogeneity index (α) were calculated,and the time signal intensity curve (TIC) was obtained.All the parameters were compared between benign and malignant breast lesions.The diagnostic performance of different parameters was evaluated with ROC curve.Results ADC,DDC and α value of malignant lesions was (1.01±0.19)×10-3 mm2/s,(0.89±0.23)×10-3 mm2/s and 0.75±0.09,while of benign lesions was (1.41±0.27)× 10-3 mm2/s,(1.49±0.29)× 10-3mm2/s and 0.87±0.07,respectively.All 3 parameters in malignant lesions were lower than those in benign lesions (all P＜0.01).Taking 1.22 × 10-3 mm2/s as the optimal threshold,the area under the curve (AUC) of DDC was the largest as 0.958,and the corresponding diagnostic sensitivity and specificity was 96.67％ and 81.82％,respectively.AUC value was 0.976 by combining DDC with TIC,and the corresponding diagnostic sensitivity and specificity was 93.33％ and 93.94％,respectively.Conclusion The stretched-exponential model DWI can differentiate breast lesions,and diagnostic performance of combination of DDC and TIC is better than ADC or DCE.

Objective:To investigate the current situation in construction and operation status of official WeChat public platform of community hospitals in Shanghai Downtown and provide the reference for effective application of WeChat public platform in community hospitals.Methods:The current situation of health service provided with WeChat public platform of community hospitals was investigated by website survey.We focused on the opening rate,menu services,information push and off-line operations of WeChat public platform from the perspective of ethics.Results:Of the investigated 98 hospitals,a total of 48 WeChat public platforms were established,accounting for 49.0％.Among which 28 public platforms provided menu bar service,accounting for 58.3％.The public platforms still needed to be improved in terms of article push quantity,reading quantity and daily management.Conclusion:The development level of WeChat public platform of community hospital in shanghai downtown is uneven and WeChat public platform of community hospital exists low service level,imperfect management,lack of publicity and other problems generally.It is recommended that hospitals strengthen the construction of WeChat platform from three aspects,including strengthening team management,keeping the "Six in One" and seeking for commercial assistance.