Objective:To understand the monkeypox knowledge awareness, risk perception and vaccination intention in men who have sex with men (MSM) in five cities in northeast China.Methods:A cross-sectional study was conducted by using electronic questionnaire in MSM selected by convenience sampling in five cities in northeast China (Shenyang, Panjin, Changchun, Harbin and Jiamusi) from June 28 to July 8, 2023 by local centers for disease control and prevention and MSM communities. The sample size was estimated to be 220. Information about their demographics, monkeypox-related knowledge awareness, perceived concern about epidemic risk perception, and monkeypox vaccination intention were collected. Logistic regression model was used to analyze related factors for MSM's monkeypox vaccination intention.Results:In 355 MSM, 63.9% (227/355) had monkeypox vaccination intentions, and 55.5% (197/355) had high awareness of monkeypox related knowledge with a mean knowledge awareness score of 3.7±1.5. MSM with education level of high-school and above (a OR=1.93, 95% CI:1.01-3.69), higher knowledge awareness score (a OR=1.19, 95% CI:1.02-1.40) and higher risk perception of monkeypox infection (a OR=1.82, 95% CI:1.15-2.88), were more willing to receive monkeypox vaccination. The main reasons for willingness to receive monkeypox vaccine were preventing monkeypox (86.3%, 196/227) and worrying about appearance being affected (62.1%, 141/227). The main reasons for unwillingness for the vaccination included concerns about vaccine safety (53.1%, 68/128), clinical progression of AIDS being affected (46.1%, 59/128) and efficacy of antiretroviral therapy being affected (44.5%, 57/128). Conclusions:The levels of knowledge awareness and vaccine intentions still need to be improved among MSM in five cities of northeast China. It is necessary to improve the awareness of monkeypox and intention of monkeypox vaccination, promote protected sex behavior and self-assessment of infection risk, reduce vaccine hesitancy and increase monkeypox vaccination intention in MSM in 5 cities in northeast China.

OBJECTIVE:To optimize the synthesis technology of 4-biphenylacetic acid,and to provide technology support to meet the market demand of 4-biphenylacetic acid raw material. METHODS:The synthesis route of 4-biphenylacetic acid from biphenyl by Friedel-Crafts reaction,ketal reaction,rearrangement reaction and hydrolysis was optimized and improved. The effects of different Friedel-Crafts reaction solvents (petroleum ether,dichloromethane,1,2-dichloroethane),ketal reaction ethanol (ethanediol, 1,3-propanediol, dimethyltrimethylene glycol, pentaerythritol), rearrangement reaction catalyzer (zinc biphenyl acetate,zinc oxide,zinc caprylate,zinc acetate) and refined solvent (isopropanol,95% isopropanol,ethanol,acetone,ethyl acetate) on synthesis technology were investigated. The optimal synthesis technology was screened with the purity and yield of intermediate or 4-biphenylacetic acid. RESULTS:The petroleum ether as Friedel-Crafts reaction solvent,ethylene glycol as ketal reaction ethanol,zinc diphenylacetate as rearrangement catalyst and 95% isopropanol as refining solvent were used for the preparation to obtain better effects. The yield of key intermediate 2′-chloroacetophenone reached above 95%. The purity of refined 4-biphenylacetic acid reached 99.9%;the content of single impurity was less than 0.1%;the total yield reached over 70%. CONCLUSIONS:The optimal synthesis technology of 4-biphenylacetic acid has the advantages of simple operation,mild and controllable reaction conditions,low cost,greener reagents and higher safety,and is suitable for industrial production. The purity and yield of the products are in high level and in line with the standards of European Pharmacopoeia and the Japanese Pharmacopoeia.

OBJECTIVE:To improve the synthesis technology of sodium picosulfate. METHODS:The synthesis technology of sodium picosulfate was improved by changing reaction solvent,charging sequence,refined method and formation of crystal water. Using phenol as raw material,it was condensed with 2-pyridinecarboxaldehyde to achieve 4,4′-(pyridin-2-ylmethylene)diphenol, and its yield rate was investigated. Sodium picosulfate was obtained after esterification,salification,formation of crystal water, and then its purity was determined. RESULTS:The yield rate of key intermediate 4,4′-(pyridin-2-ylmethylene) diphenol reached above 88%,and the purity of refined products reached over 99.5%. Sodium picosulfate monohydrate was stable,and the content of single impurity was less than 0.1%. CONCLUSIONS:The improved technology is simple with mild conditions,and suitable for large-scale production.

Toutianliang manipulation is the most representative compound needling technique of traditional reinforcing and reducing and has the remarkable efficacy on heat syndrome with muscle and bone involved for example. Professor ZHANG Jin is one of the famous acupuncture master in China and has contributed his lifelong to the research of acupuncture manipulation techniques. He has summarized 24 single-type manipulations and has given the comprehensive explanation of the manipulations for meridian conduction, reinforcing or reducing techniques for the excess or deficiency. In the paper, Toutianliang manipulation was introduced briefly and the key operation steps had been discussed.
Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans

Objective: To explore the safety and efficacy of left atrial (LA) endocardial vagal denervation catheter ablation for treating the patients with refractory vasovagal syncope (VVS).
Methods: A total of 57 consecutive refractory VVS patients with severe symptom and positive response to head-up tilt test (HUT) were enrolled. There were 22 male at the mean age of (43 ± 13) years. The patients had no response or couldn’t tolerate routine treatment. LA model was re-established by three-dimensional mapping system, 10 patients received high-frequency stimulation technique for ganglionated plexi (GP) ablation and 47 received regional catheter ablation at 5 anatomic sites of GP for LA endocardial vagal denervation treatment. In-operative vagal response including hypotension, sinus bradycardia or asystole were observed, the endpoint of ablation was abolition of evoked vagal relfexes. Periodical follow-up was conducted to record the syncope recurrence and to re-examine ECG and HUT in all patients.
Results: There were 52/57(91.2%) patients had positive vagal response by radiofrequency application and reached the endpoint of ablation; 4 patients couldn’t receive obvious evoked vagal relfexes. During (36 ± 22) months follow-up period, there were 52 (91.2%) cases without syncope recurrence, 11 cases still having palpitation, amaurosis and dizziness as the precursors of syncope while the symptoms were much better then they were before. No complication occurred.
Conclusion: LA endocardial vagal denervation catheter ablation is a safe and effective method for treating the patients with refractory VVS, it may also effectively prevent VVS recurrence.

Objective: To quantitatively evaluate the abnormal tense of parasympathetic nerve via measuring the heart rate deceleration capacity (DC) and heart rate variability (HRV) in patients with vasovagal syncope (VVS).
Methods: Our research included 2 groups: VVS group,n=28 patients with positive head-up tilt test treated in our hospital from 2013-06 to 2014-08 and Control group,n=30 patients without cardiovascular disorders. The DC and HRV were examined and compared between 2 groups.
Results:① The overall deceleration capacity (ODC) (9.4 ± 2.9) ms and daytime deceleration capacity (DDC) (8.9 ± 2.9) ms in VVS group were higher than those in Control group (7.5 ± 2.5) ms and (7.5 ± 2.5) ms respectively,P<0.05.② More patients in VVS group presented daytime-to-nighttime deceleration capacity ratio (DNratio) >1 than those in Control group (9/28, 32.1% vs 2/30, 6.7%),P=0.019.③ The SDNN (139.8 ± 34.0) ms, SDSD (29.9 ± 15.7) ms and rMSSD (40.9 ± 18.8) ms in VVS group were higher than those in Control group, (115.5 ± 29.4) ms, (21.8 ± 6.6) ms and (28.9 ± 8.4) ms respectively,P<0.05.④ Multivariate Logistic regression analysis indicated that ODC was positively related to vasovagal syncope occurrence (OR=2.045, 95% CI: 1.100-3.801,P=0.024).
Conclusion: VVS patients have abnormally increased indexes of DC and HRV, HDC is the predictor for vasovagal syncope occurrence.

Objective To explore the diagnosis and treatment of cystic pancreatic tumors. Methods The clinical data of 21 cases with cystic pancreatic tumors were retrospectively analyzed. Results This group enrolled 21 cases including serous cystic neoplasm of the pancreas (SCN, 11 cases), mucinous cystic neoplasm of the pancreas (MCN, 6 cases), intraductal papillary mucinous neoplasms (IPMN,2 cases), solid posudopapillary tumor of the pancreas (SPTP,2 cases). Seven cases had certain symptoms or typical signs, while others were asymptomatic and tumors were found by regular physical examinations. All of the cases were diagnosed by CT scans, and the value of serum tumor markers was within normal range. Twenty patients underwent pancreatic tumor resections and there was no perioperative death. Pancreaticoduodenectomy was performed in 8 cases, and distal pancreatectomy was performed in 6 cases including 1 patient undergoing laparoscopic distal pancreatectomy. Middle segment resection was performed in 4 cases, and tumor enucleation was performed in 2 cases. These 20 patients were followed up for 11 to 96 months, and there was no tumor recurrence or metastasis. One patient with mucinous cystic carcinoma underwent palliative operation and survived 4 months after surgery. Conclusions Preoperative imaging was not able to confirm the definite tumor pathological category. Laparotomy should be performed in a patient with cystic pancreatic tumor. The selection of surgical approach should be individualized, and the laparoscopic operation is an alternative.

Objective To study the expression of epidermal growth factor receptor (EGFR) in cervical car-cinoma and cervical intraepithelial neoplasia(CIN),and to elucidate its relation with the genesis, infiltration, metas-tasis and prognosis of cervical carcinoma. Methods EGFR was determined by means of S-P immunohistochemistry in tissue of 100 cases of cervical carcinoma,60 cases of CIN and 40 cases of controls. Results The overexpression rates of EGFR were 0% (0/40), 51.67% (31/60),78.00% (78/100), respectively in normal cervical epithelium, CIN and cervical tumor tissues. The overexpression rate of EGFR was significantly higher in cervical tumor tissue than in control group(P<0.01). The overexpression of EGFR didn't demonstrate significant association with clinical staging, tumor size, pathological type, differentiation, cervical invasion depth, cervical canal invasion, lymphnode me-tastasis or the prognosis of cervical neoplasm (P>0.05). Conclusion Overexpression of EGFR is worsened with the severity of cervical lesion, suggesting that overexpression of EGFR is correlated with the genesis of cervical neo-plasms,which may be a valuable biological indicator of cervical carcinoma,but is not correlated with clinical patho-logical features and prognosis of cervical carcinoma.

Objective:To determine the diagnostic value of multislice CT urography (MSCTU) in patients with transitional cell carcinoma ( TCG) of upper urinary tract by comparing other imageology methods used. Methods: Two hundred and thirty four cases of transitional cell carcinoma of upper urinary tract, in which 82 cases were diagnosed pathologically with pelvic carcinoma and 152 cases with ureteral carcinoma, between June 2004 and September 2006 in our institute were enrolled in a retrospective study. Most of them underwent urological ultrasound, intravenous urogram (IVU) , retrograde pyelography and MSCTU. We compared the positive rate (PR) and diagnostic rate (DR) of these methods used by chi-square test. Results: Among the 234 cases, 215 patients underwent urologic ultrasound, in which 152 cases were detected to be abnormal, with the PR of 70.1% ;Meanwhile, 58 cased were diagnosed by this examination, with the DR of 27. 0%. IVU was performed in 193 patients and 132 cases were found to be abnormal, and the PR was 68. 4% , 65 cases were diagnosed by IVU and the DR was 33.7%. And 132 patients underwent retrograde pyelography, by which 115 cases of lesion were detected, with the PR of 87. 1% ; In the meantime, 93 cases were diagnosed, with the DR of 70. 5%.MSCTU was performed in 226 cases and 220 cases were found to be abnormal, and the PR was 97.3% ;214 cases were diagnosed by MSCTU, with the DR of 94. 7%. The DR of detecting TCC of retrograde pyelography had statistically significant difference with that of ultrasound and IVU(P＜0.001). As compared with retrograde pyelography, MSCTU had statistically significant superiority (P＜0.001). Conclusion: To shorten the diagnosis time and mitigate the sufferings, patients with hematuria supposed to be TCC of upper urinary tract should be recommended to undergo MSCTU first.

Objective To investigate the expression of vascular endothelial cell growth factor-C (VEGF-C) and its receptor--vascular endothelial cell growth factor receptor-3 (VEGFR-3) in breast cancer tissue and its correlation with metastasis of lymphonodi axillares.Methods Fifty-eight cases of breast cancer samples and 10 cases of tumor adjacent non-carcinomatous tissue were measured by immunohistochemical staining for expression of VEGF-C and VEGFR-3. Their expression rates were compared between axillary lymph node metastasis and non-metastasis groups.Results The positive rates of VEGF-C and VEGFR-3 as well as the number of VEGFR-3 positive vessels were significantly higher than those in lymph node non-metastasis group (87.5% vs 55.9%; 83.3% vs 38.2%; 8.54±2.54 vs 4.73±2.46, respectively).Conclusion The high expression of VEGF-C and VEGFR-3 as well as the increase in the number of VEGFR-3 positive vessels are related to lymph node metastasis of human breast cancer. VEGF-C/VEGFR-3 system may be a new specific target which contributes to blockage of lymphatic metastasis in breast cancer.