Objective:To investigate the effects of salt induced kinase 1(SIK1)in the effects of aerobic exercise on neu-roinflammatory response and spatial learning and memory function in aging mice. Method:Fifty-four male C57BL/6 mice were divided into three groups:the young group(group C,n=18),the aging control group(group A,n=18),and the aging exercise group(group E,n=18).Mice in groups C and A were fed naturally,while the mice in group E were subjected to aerobic treadmill exercise intervention for 8 weeks.Morris water maze training and testing were used to evaluate mice's spatial learning and memory abili-ties.Transcriptome sequencing was used to screen the differential genes.Immunofluorescence was used to detect the fluorescence intensity of ionized calcium-binding adaptor molecule 1(Iba-1).The mRNA and protein expres-sion levels of SIK1,nuclear factor kappa-B(NF-κB)and interleukin 1β(IL-1β)were detected by real-time PCR and Western Blot. Result:The mean escape latency was prolonged and the number of crossings of the original platform was re-duced(P＜0.01)for learning and memory function-related indicators in aging mice;hippocampal neurons were significantly disrupted and microglia(MG)activation-related gene Iba-1 fluorescence intensity was increased(P＜0.01);transcriptome levels were disturbed,with 175 genes upregulated and 66 genes were downregulated;inflammation-related genes SIK1,NF-κB mRNA(P＜0.05,P＜0.01)and protein(P＜0.01,P＜0.01)expression was elevated and IL-1β mRNA expression was increased(P＜0.05).After exercise intervention,the mean es-cape latency was reduced and the number of crossing the original platform was increased in aging mice(P＜0.01),attenuated neuronal damage,reduced Iba-1 fluorescence intensity(P＜0.01),upregulation of 19 genes,downregulation of 12 genes,reduced expression of SIK1,NF-κB mRNA(P＜0.01,P＜0.05)and protein(P＜0.05,P＜0.05),and IL-1β protein expression was reduced(P＜0.05). Conclusion:Eight weeks of aerobic exercise can reduce the expression of hippocampal SIK1 and its down-stream NF-κB and IL-1β in aging mice,inhibit MG activation,reduce neuroinflammation,and ultimately im-prove spatial learning and memory function.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

OBJECTIVE：To study the effects of virus in activation treatment of plasma specimen on plasma concentration determination of voriconzole ，linezolid，vancomycin and teicoplanin. METHODS ：The remaining plasma of 36 inpatients in our hospital after routine blood concentration examination of voriconazole ，linezolid，vancomycin and teicoplanin were collected as specimen（9 drug-contained plasma specimens for each drug ），and merged into three different concentration levels （low，medium， high）of mixed samples according the results of routine blood test. Then the mixed samples with different concentration levels were divided into inactivated group and non-inactivated group ，with 3 samples in each group. The inactivated plasma samples were heated at 56 ℃ for 30 min in metal bath with constant temperature. Non-inactivated group were not treated. After pretreating plasma sample of 2 groups，2-dimensional liquid chromatography was used to detect plasma concentration of the four drugs ；the difference of detection result between inactivated group and non-inactivated group were analyzed. RESULTS ：Plasma samples containing voriconazole，linezolid，vancomycin and teicoplanin were still stable after heating at 56 ℃ for 30 min in metal bath with constant temperature. Compared with non-inactivated group ，relative error of plasma concentration detection result of above 4 drugs were all lower than 15％ in low ，medium，high concentration mixed samples of inactivated group. CONCLUSIONS ：Plasma samples can be inactivated by heating at 56 ℃ for 30 min in metal bath with constant temperature ，when the plasma concentration of voriconazole，linezolid，vancomycin and teicoplanin are determined by 2-dimensional liquid chromatography.

Statistics show that 76.74% (4 688) of 6 109 patients with chronic wounds are those over 50 years of age; the proportion of patients with underlying diseases in all age groups above 50 years ranges from 78.25% to 100.00%; among the underlying diseases of chronic wound patients, the top four diseases are diabetes mellitus , cardiovascular and cerebrovascular diseases, hypertension, and respiratory diseases. The above underlying diseases and ages of patients are the susceptibility factors of corona virus disease 2019 released by National Health Commission of China. It is an unavoidable fact that patients with chronic wounds have to go to the hospital for treatment prescribed by the physician. At the same time, we found that there were not a few patients who go far afield because of various reasons when go to the hospital for treatment. During the period of epidemic prevention and control, this kind of "go far afield" style of seeking medical treatment may increase the exposure risk during transportation. Accordingly, we convened 36 wound care clinics in different regions in Shanghai to implement the "Five Measures" to encourage patients with chronic wounds to seek medical treatment proximately. The principle of this operation is that when seeking medical treatment, trying our best to reduce as much as possible the transportation distance for patients with chronic wounds to minimize the exposure risk during the epidemic period and eventually support the epidemic prevention and control campaign.

The prevention and treatment of scars has always been an important task in the field of wound repair.Humans have started treatment for scars long time ago and have created a series of treatments.At the same time,with the development of science and technology,the diagnosis and treatment of scars have made great progress.Through the basic research for new therapeutic targets and innovative of treatment methods,treatment for scar turns more diversified and integrated.As a result,clinicians will suffer many challenges while having more options for scars treatment.Combined with traditional treatment,developing new treatments,and the comprehensive therapy of multiple treatment methods is the mainstream trend of scar treatment.

Objective To investigate the abuse tendency of disabled elderly caregivers and analyze its causes.Methods With the convenience sampling method,The main caregivers of 300 disabled elderly people were investigated by the general questionnaire, Activities Daily Living Scale (ADLs) and Caregiver Abuse Screen (CASE) in Guangzhou. Results The degree of disability of the elderly was moderate to severe degree.The average score of the elderly caregiver′s propensity for abuse tendency was(3.3 ± 2.3).178 (59.4 %, 178/300) of the elderly caregivers have abuse tendency (the average score was more than 3). Conclusion Caregivers′ abuse tendency against the elderly is high. The situation of the elderly is not optimistic.

Objective To cultivate specialist nurses to perform preoperative stoma site marking in patients to receive enterostomy and improve the rate of preoperative stoma site marking and the ability of preoperative stoma site marking in specialist nurses. Methods The rate of preoperative stoma site marking in 148 patients from July 2016 to October 2016 was investigated and the reason of not receiving preoperative stoma site marking was analyzed. Nineteen primary nurses were trained to perform preoperative stoma site marking instead of the traditional pattern which was performed by enterostomy therapist and physician. The training included the criteria of preoperative stoma site marking, difficult preoperative stoma site marking, demonstration, group exercises, theoretical and operational assessment. The preoperative stoma site marking of 156 patients were performed by specialist nurses from November 2016 to February 2017.Then,the rate of preoperative stoma site marking,accuracy of stoma location,and knowledge of preoperative stoma site marking were compared between the traditional and new management pattern. Results The preoperative stoma site marking rate was 91.89%(136/148)and the accuracy rate was 94.12%(127/136)in traditional management pattern.The lack of enterostomy therapist, surgery performed on weekends and emergency surgery were the reasons that preoperative stoma site marking was not performed.After changing the management pattern,the preoperative stoma site marking rate was increased to 98.72%(154/156) and there was a significant difference between them (χ2=8.06, P <0.05).The accuracy of localization was decreased to 92.86%(143/154),but there was no significant difference between them(χ2=0.03,P>0.05).The rate of acquiring preoperative stoma site marking knowledge in nurses was increased from 8/19 to 18/19 with a significant difference(χ2=12.18,P<0.01). Conclusions The pattern of preoperative stoma site marking was changed and the new pattern improved the rate of preoperative stoma site marking,and didn′t affect the accuracy of preoperative stoma site marking.Meanwhile,we also improved the nurses′level of preoperative stoma site marking in our department.

Objective To investigate the epidemiological and clinical features of brucellosis in Foshan.Methods The epidemiological history,clinical manifestations,laboratory tests,treatment and outcomes of 41 patients with brucellosis from 2013 to 2016 in the First People's Hospital of Foshan were retrospectively analyzed.Results Brucellosis onsets occurred mainly from February to June [85.4％ (35/41)],and 58.5％ (24/41) of them had positive epidemic history.Irregular fever,rachialgia/arthralgia,fatigue and hepatosplenomegaly occurred in 29 (70.7％),20 (48.8％),19 (46.3％) and 16 (39.0％) of the patients,respectively.The C-reactive protein (hs-CRP) of patients infected with Brucella only was lower than that in patients infected also with other bacteria (26.72 vs 50.87 mg/L,Z =-2.300,P ＜ 0.05),but no significant difference of white blood cell counts (5.77 × 109/L vs 5.83 × 109/L),neutrophil (3.50 × 109/L vs 3.84 × 109/L) and procalcitonin (PCT,0.10 vs 0.14 μg/L) between the two groups were observed.The patients with positive epidemic history had lower white blood cell,neutrophil and monocyte counts than those who did not had epidemic history (4.73 × 109/Lvs 7.28 × 109/L,2.73 × 109/L vs 4.79 × 109/L,and 0.36 × 109/L vs 0.64 × 109/L;F =9.486,10.130,9.785,P ＜ 0.05).And no significant difference of lymphocyte counts,hs-CRP and PCT between the two groups were observed (1.57 × 109/L vs 1.73 × 109/L,29.30 vs 35.76 mg/L,and 0.15 vs 0.09 μg/L;P ＞ 0.05).All the cases were infected by Brucella melitensis,and 33 of them were sensitive to general antibiotics in vitro.There were 40 cases discharged after treatment,and 34 cases still needed to increase antibiotic treatment courses.Most patients had good outcomes.Conclusions In Foshan,patients with irregular fever and rachialgia or arthralgia,and no significantly increased inflammation index,should be aware of brucellosis.We should strengthen the screening of brucellosis in Foshan.

OBJECTIVE: To improve the quality standard of Folium Mahoniae. METHODS: TLC was used for qualitative identification. The contents of moisture, ash and ethanol extract were determined. The content of berberine hydrochloride was determined by HPLC. The determination was performed on WondaSil C18 column with mobile phase consisted of acetonitrile-0. 05 mol/L monopotassium phosphate solution (25: 75, V/V) at the flow rate of 1. 0 mL/min. The detection wavelength was 264 nm, column temperature was 30 ℃, and sample size was 10 μL. RESULTS: TLC spots were clear and well-separated. The contents of moisture, total ash, acid-insoluble ash and ethanol extract were 3. 92％-7. 03％, 3. 65％-6. 95％, 0. 05％-1. 03％ and 10. 87％-33. 14％, respectively. The linear range of berberine hydrochloride was 0. 183-0. 915 μg(r=0. 999 9); quantitation limit and detection limit was 0. 143, 0. 095 μg, respectively. RSDs of precision, stability and reproducibility tests were lower than 2. 0％ (n=6); recovery was 95. 21％ -103. 10％ (RSD = 2. 95％, n=6). CONCLUSIONS: The content of moisture, total ash and acid-insoluble ash of medicinal materials is not exceed 8. 0％, 6. 0％ and 0. 4％, respectively. The content of ethanol extract and berberine hydrochloride is not less than 16. 0％ and 1. 0％, respectively. Established standard can be used for quality control of Folium Mahoniae.

Objective To explore the correlation between resilience and psychological status of main caregivers among disabled elderly of Guangzhou region.Methods From June 2015 to December 2015, a total of 300 main caregivers of disabled elders were investigated with the general information questionnaire, the Chinese version of Connor-Davidson Resilience Scale (CD-RISC), Activities Daily Living Scale (ADLS), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) by convenience sampling.Results The total score of resilience, standard score of anxiety and depression were (58.2±15.8), (49.05±10.5) and (51.73±11.52) respectively among main caregivers of disabled elders. The competence dimension of CD-RISC had negative correlations with anxiety (r=-0.260,P<0.01) and depression (r=-0.316,P<0.01) in main caregivers of disabled elders, and the toughness dimension was negatively correlated with the depressive symptoms (r=-0.147,P<0.05).Conclusions Main caregivers of disabled elderly of Guangzhou region are with poor resilience along with the high ratio of detection in anxiety and depression suggesting that the mental status is not optimistic.