Objective To establish an early prediction model for the diagnosis of severe acute pancreatitis based on the improved machine learning models,and to analyze its clinical value.Methods A case-control study was conducted on 352 patients with acute pancreatitis admitted to the Gastroenterology and Hepatobiliary Surgery Departments of the Army Medical Center of PLA and Emergency and Critical Care Medicine Department of No.945 Hospital of Joint Logistics Support Force of PLA from January 2014 to August 2023.According to the severity of the disease,the patients were divided into the severe group(n=88)and the non-severe group(n=264).The RUSBoost model and improved Archimead optimization algorithm was used to analyze 39 routine laboratory biochemical indicators within 48 h after admission to construct an early diagnosis and prediction model for severe acute pancreatitis.The task of feature screening and hyperparameter optimization was completed simultaneously.The ReliefF algorithm feature importance rank and multivariate logistic analysis were used to analyze the value of the selected features.Results In the training set,the area under curve(AUC)of the improved machine learning model was 0.922.In the testing set,the AUC of the improved machine learning model reached 0.888.The 4 key features of predicting severe acute pancreatitis based on the improved Archimedes optimization algorithm were C-reactive protein,blood chlorine,blood magnesium and fibrinogen level,which were consistent with the results of ReliefF algorithm feature importance ranking and multivariate logistic analysis.Conclusion The application of improved machine learning model analyzing the laboratory examination results can help to early predict the occurrence of severe acute pancreatitis.

ObjectiveTo analyze the epidemiological characteristics and trends of influenza‑like illness (ILI) in Jiading District from 2013 to 2023, to explore the prevalence patterns, so as to provide a scientific basis for a better prevention and control of influenza. MethodsData of ILI cases, pathogenetic surveillance results and pathogen detection data from influenza surveillance network laboratories in Jiading District from 2013 to 2023 were collected for statistical analysis. ResultsFrom 2013 to 2023, the overall proportion of medical visits for ILI cases in Jiading District was 2.70%. ILI cases were mainly distributed in the age group of ≥25 years, with a seasonal prevalence characteristic, mainly concentrated in the winter and spring, with an occasional small peak in the summer. A total of 12 423 specimens were tested for pathogenetic surveillance and monitoring, 3 651 of which were tested positive for nucleic acid detection, with a positive rate of 29.39%. The dominant strain was influenza A (H3N2) virus, accounting for 55.05%. There were statistical significant differences in the positive detection rates by different streets and townships(χ²=24.73，P<0.05）. The influenza network laboratory isolated and cultured influenza viruses from 3 154 nucleic acid‑positive samples sent by national influenza sentinel surveillance hospitals using 2 methodsMadin‑Darby canine kidney (MDCK) cells and specific pathogen free (SPF) chicken embryos, respectively, with a total isolation rate of 39.51%, and the isolation rate of MDCK cells (35.45%) was higher than that of SPF chicken embryos (5.36%). From 2013 to 2023, a total of 14 ILI outbreaks were reported in Jiading District, mainly in primary schools, kindergartens and secondary schools. ConclusionInfluenza in Jiading District, Shanghai, is mainly prevalent in the winter and spring, with different subtypes of influenza viruses alternating or co⁃circulating in different monitoring year. It is recommended to promote influenza vaccination, further improve influenza prevention and control measures, enhance health promotion to the age group of ≥25 years in winter and spring, and strengthen surveillance and monitoring on ILI outbreaks in collective units such as primary schools and childcare institutions, so as to reduce the disease burden.

Ziziphi spinosae semen mainly contains contents of saponins,flavonoids,alkaloids and aliphatic acids.Meanwhile,it has a variety of activities such as sedative-hypnotic,anti-anxiety,anti-depression,nerve protection,cardiovascular and cerebrovascular protection,liver protection,and antioxidant,which is widely used in medicine,food,health food and other fields.The chemical constituents,pharmacological action and clinical application of Ziziphi spinosae semen were systematically summarized in this paper by reviewing the literature,in order to provide theoretical guidance for the sustainable development of the resources and the rational use of Ziziphi spinosae semen.

Objective:To investigate the role of CD8 + T cells in lethal Plasmodium yoelii 17XL ( Py 17XL) infection. Methods:BALB/c mice and C57BL/6 mice were infected with Py 17XL-infected red blood cells (1×10 6 cells/0.1 ml) through intraperitoneal injection to establish the mouse models of Py 17XL infection. Parasitemia (the percentage of erythrocytes infected with Py 17XL) and the survival rates of the mice was observed dynamically. Flow cytometry was used to detect the number of effector T cells (T EFF) and central memory T cells (T CM) of CD8 + T cell subpopulations, the expression of IFN-γ and granzyme B (GB) levels, and the expression of surface chemokine receptors CXCR3, CXCR6 and CX3CR1. FTY720 blocking experiment was conducted on Py 17XL-infected C57BL/6 mice to analyze the impact of CD8 + T cell migration on Py 17XL infection. Results:The parasitemia of BALB/c mice increased rapidly 5 d after infection and reached the peak on 8 d [(79.57±3.82)%]. Besides, the parasitemia was higher in BALB/c mice than in C57BL/6 mice 5-8 d after infection ( P<0.000 1). All BALB/c mice died on 9 d. The parasitemia of C57BL/6 mice reached the peak on 14 d [(48.19±3.19)%] and then decreased to 0 on 26 d. There was statistically significant difference in the survival rate between the two groups ( P<0.000 1). Flow cytometry results showed that compared with the BALB/c mice, the absolute number of CD8 + T cells in spleen and liver tissues and the number of CD8 + T EFF and CD8 + T CM cells in spleen and lymph nodes of C57BL/6 mice increased significantly ( P<0.05). Compared with the BALB/c mice, the levels of GB, IFN-γ and chemokines expressed by CD8 + T cells in spleen and liver tissues of C57BL/6 mice increased significantly ( P<0.05). The FTY720 blocking experiment showed that the survival rate, the absolute number of CD8 + T cells in liver and spleen, and the number of CD8 + CXCR3 + T cells decreased significantly in the experimental group ( P<0.05). Conclusions:CD8 + T EFF and CD8 + T CM cells contribute to resistance against Py 17XL infection by secreting GB and IFN-γ. The chemokine receptor CXCR3 plays an important role in mediating the chemotaxis of CD8 + T cells to spleen and liver.

At present， there is a lack of unified and standardized management for the rational use of national key monitoring drugs. According to the relevant requirements of the state， based on the relevant literature published at home and abroad in recent years and combined with the management practice of many medical institutions across the country on the national key monitoring drugs， in order to make the national key monitoring drugs more reasonable use and standardized management in medical institutions at all levels， the Clinical Pharmacy Branch of the Chinese Medical Association， the Pharmaceutical Epidemiology Special Committee of the Chinese Pharmaceutical Association and the Pharmaceutical Epidemiology Special Committee of the Sichuan Pharmaceutical Association organized experts to fully discuss， and to form this management standard. This standard mainly provides relevant opinions and suggestions on the basic principles of rational use of key monitoring drugs and the regulatory measures for key monitoring drugs， especially on how to strengthen the pharmaceutical management and use management of key monitoring drugs， further promoting the standardized use of key monitoring drugs.

Objective:To investigate the levels of serum IgM, IgG, IgA and neutralizing antibodies (NAbs) in convalescing patients infected with the novel coronavirus and their diagnostic significance.Methods:Five hundreds and eighty one infected patients and 219 non-infected patients were detected by chemiluminescence method . The positive rate of antibody and antibody level were statistically analyzed for statistical significance. The correlation between the antibodies was compared, and the ability of each antibody to identify breakthrough infection in the vaccinated population was evaluated by combining ROC curve.Results:The antibody titers of IgM, IgG, NAbs and IgA in infected patients were higher than those in uninfected individuals. The antibody positive rate and antibody level of infected persons who were vaccinated and not vaccinated, with different ages, different doses of vaccines, and different intervals of vaccination were statistically significant ( P<0.05); IgA antibody levels were positively correlated with IgG and NAbs, and NAbs is positively correlated with IgG antibody; In breakthrough infection analysis, IgG, IgA and NAbs antibodies were good at identifying infected persons in the vaccinated population. Conclusions:The positive rate of IgM antibody is low in the convalescence period, which is of little significance for monitoring the course of COVID-19 and evaluating the efficacy of vaccines. In addition, the antibody level and positive rate can be significantly improved by the booster injection of COVID-19 vaccine. Differences in IgG, IgA, and NAbs antibody levels can be used to identify breakthrough infection cases from vaccinated populations.

SARS-CoV-2 infection causes complicated clinical manifestations with variable multi-organ injuries, however, the underlying mechanism, in particular immune responses in different organs, remains elusive. In this study, comprehensive transcriptomic alterations of 14 tissues from rhesus macaque infected with SARS-CoV-2 were analyzed. Compared to normal controls, SARS-CoV-2 infection resulted in dysregulation of genes involving diverse functions in various examined tissues/organs, with drastic transcriptomic changes in cerebral cortex and right ventricle. Intriguingly, cerebral cortex exhibited a hyperinflammatory state evidenced by significant upregulation of inflammation response-related genes. Meanwhile, expressions of coagulation, angiogenesis and fibrosis factors were also up-regulated in cerebral cortex. Based on our findings, neuropilin 1 (NRP1), a receptor of SARS-CoV-2, was significantly elevated in cerebral cortex post infection, accompanied by active immune response releasing inflammatory factors and signal transmission among tissues, which enhanced infection of the central nervous system (CNS) in a positive feedback way, leading to viral encephalitis. Overall, our study depicts a multi-tissue/organ transcriptomic landscapes of rhesus macaque with early infection of SARS-CoV-2, and provides important insights into the mechanistic basis for COVID-19-associated clinical complications.
Animals ; COVID-19/genetics* ; Macaca mulatta ; SARS-CoV-2/genetics* ; Transcriptome

Objectives To observe the clinical curative effect of Wuzhuyu acupoint on the treatment of gastrointestinal dysfunction in severe patients. Methods A total of 60 patients with gastrointestinal dysfunction were randomly divided into treatment group and control group, 30 patients in each group. The control group was treated with routine western medicine, and the treatment group was given the acupoint application of Wuzhuyu on the basis of routine treatment. The treatment last 7 days. The clinical efficacy was evaluated by observing bowel sounds recovery time, exhaust time and defecating time, enteral nutrition tolerability, gastrointestinal dysfunction score and acute physiology and chronic health evaluation (APACHE Ⅱ). Results The treatment group showd significantly shorter bowel sound recovery time and anal exhaust time than the control group (t value were 8.811, 5.538, 8.908, all P value <0.01). The enteral tolerance rate was 80.0％ (24/30), and the control group tolerance rate was 53.3％ (16/30). The tolerance rate of treatment group was significantly higher than that of control group (χ2=4.720, P=0.030). The Gastrointestinal dysfunction score and APACHE Ⅱ score in treatment group were significantly lower than control group (t value were 3.873,2.805,all P value <0.01). Conclusions The acupoint application of Wuzhuyu can promote the recovery of gastrointestinal function, increase the tolerance of enteral nutrition, and reduce the severity of the patient's condition and improve the prognosis of patients.

Objective To explore the effects of cyclophosphamide administered by different routes or in different doses on the embryo-fetal development in pregnant rabbits, and to determine the optimal mode of cyclophosphamide administration to induce fetal malformation.Methods Pregnant rabbits were divided into control group C (saline), group Y1 (intravenous injection of 15 mg/kg cyclophosphamide,), group Y2 (subcutaneous injection of low dose cyclophosphamide, 20 mg/kg), and group Y3 (subcutaneous injection of high dose cyclophosphamide, 30 mg/kg).Each rat was administrated according to the corresponding mode once daily on GD10~13.The day of conception was designated as GD0.The pregnant rabbits were sacrificed and dissected on GD28.Then, the number of corpora lutea and implantation, the weight of uterus with contained fetus, and fetal resorption rate were detected, the fetuses were removed and the fetal sex, body length, tail length, the number of live births and stillbirths were recorded, and the appearance of deformities, visceral deformities and skeletal malformations were detected.Results Pregnant rabbit fetuses in the cyclophosphamide intravenous injection group and subcutaneous injection of low dose cyclophosphamide group showed deformities.The appearance malformation rates in the two groups were 30.77% and 95.65%, the skeletal deformity rates were 7.69% and 73.91%, and the visceral abnormality rates were 20.51% and 47.83%, respectively.The fetal resorption rate in the high dose cyclophosphamide subcutaneous injection group was 100%.Conclusions Subcutaneous injection of 20 mg/kg cyclophosphamide to pregnant rabbits at GD10~13 can be used as a positive administrationmethod for rabbit embryo-fetal developmental toxicity test.Thismethod has the advantages of short administration period, easy operation, few fetus resorption, and high rate of fetal malformation, thus, providing the evidence for selection of appropriate model of rabbit embryo-fetal developmental toxicity.

Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.