Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

OBJECTIVE To study the absorption characteristics of phenylpropanoids of Mongolian medicine Tabson-2 decoction(TBD) in Caco-2 cells and to preliminarily clarify the oral absorption mechanism of TBD. METHODS Caco-2 cell monolayer model was used to analyze the uptake components of TBD in Caco-2 cells by UPLC-MS/MS, and UPLC-MS/MS analysis method was established to determine the nine best absorbed components of TBD, protocatechuic acid, neochlorogenic acid, chlorogenic acid, cryptogenic acid, 1,5-dicaffeinate quinic acid, isochlorogenic acid C, caffeic acid, dihydrocaffeic acid, chlorogenic acid. The effects of time, concentration and P-glycoprotein inhibitor on the absorption of each component were investigated. RESULTS The overall intake of caffeic acid and dihydrocaffeic acid showed an upward trend in 0-180 min, and did not show saturation. The absorption of 3-hydroxycinnamic acid was constant at about 90 min and tended to saturation. The intakes of cryptochlorogenic acid, 1,5-dicaffeinate, quinic acid, isochlorogenic acid C, neochlorogenic acid, chlorogenic acid and protocatechuic acid first decreased and then increased with time from about 90 min. The addition of P-glycoprotein inhibitor verapamil and cyclosporin A had an effect on the absorption of dihydrocaffeic acid compared with the phenylpropanoid components, indicated that dihydrocaffeic acid was the substrate of P-glycoprotein. CONCLUSION The main phenylpropanoids of TBD enter Caco-2 mainly by passive diffusion, supplemented by active transport, and the absorption process of the other eight components is not affected by the efflux of P-glycoprotein except dihydrocaffeic acid.

Objective:To analyze the health literacy level among medical staff and its influencing factors.Methods:Using the convenient sampling method, the in-service medical staff from four medical institutions (Shanghai Pudong New Area People′s Hospital, Shanghai Pudong New Area Zhoupu Hospital, Shanghai Tenth People′s Hospital Chongming Branch, and Shanghai Jing′an District Zhabei Central Hospital) were administered with a national residents′ health literacy questionnaire uniformly compiled by the China Health Education Center, and an electronic questionnaire independently compiled in combination with professional characteristics of the medical staff. The survey period was January 5-17, 2021. The contents of the questionnaire included basic information regarding gender, age, education, and professional title. Respondents were also asked whether they had chronic diseases, and three aspects of health literacy for basic knowledge and concepts, healthy lifestyle and behavior and health skills covering six other types of health problems including scientific outlook on health, infectious disease prevention and control literacy, chronic disease prevention and control. Safety and first aid literacy, basic medical literacy, health information literacy were also assessed. The total score for the questionnaire was 100 points. Respondents with a score of 80 or more were considered to have a competent health literacy. A total of 870 questionnaires were distributed, excluding incomplete ones, 826 valid questionnaires were used for analysis. Logistic regression was used to analyze factors influencing the health literacy among medical staff.Results:The overall health literacy level of medical staff was 64.0%, with 79.7% of respondents indicating that they had basic knowledge and concepts, 70.8% indicating that they practiced healthy lifestyles and behaviors, and 33.5% showed proficiencies in terms of health skills. From high to low, the health literacy levels for the six types of health problems were safety and first aid literacy (80.5%), scientific outlook on health (76.4%), infectious disease prevention and control literacy (60.2%), chronic disease prevention and control literacy (70.9%), basic medical literacy (52.7%), and health information literacy (50.2%). The results of a multivariate logistic regression analysis showed that physical condition, a lifestyle harmful to one′s health, highest educational background, and a professional title in the previous year were the independent influencing factors related to health literacy ( P<0.05). Conclusion:Levels of health skills, basic medical literacy, and health information literacy among medical staff are low, and physical condition in the previous year, lifestyle, professional title, and education are important factors influencing the level of health literacy among medical staff.

Objective:To evaluate whether the decrease in peripheral blood monocyte count was a potential predictor for neutropenia in patients with nasopharyngeal carcinoma and cervical cancer.Methods:The medical records of 95 patients with nasopharyngeal carcinoma and cervical carcinoma who received intensity-modulated radiation therapy (IMRT) combined with paclitaxel liposomes and platinum (TP) synchronous chemotherapy and presented with neutropenia in the Second Affiliated Hospital of Soochow University from January 2017 to December 2018 were retrospectively analyzed. Paired sample t-test was used to assess whether the number of days when the monocytes initially dropped/decreased to lowest level/eventually increased to normal value was significantly less than those of the neutrophils. In addition, the chi-square test was performed to determine the correlation between the degree of reduction in the absolute neutrophil count (ANC) and baseline absolute monocyte count (AMC). Results:The change trend of AMC was consistent with that of ANC in the two cycles of concurrent chemotherapy. The number of days when AMC initially decreased/decreased to the lowest level/finally increased to normal value was significantly less than that of ANC (4 d vs. 6 d, 4 d vs. 10 d, P<0.001; 5 d vs. 6 d, 6 d vs. 9 d, 7 d vs. 12 d, P<0.001). However, no correlation was found between the baseline level of monocytes and the degree of subsequent neutropenia [(AMC<0.4×10 9) vs.( AMC≥0.4×10 9)=32 vs. 63, P=0.172]. Conclusions:Decreased monocyte count is an important potential predictor for neutropenia and a significant indicator for guiding the next monitoring of neutrophil count and treatment with granulocyte colony-stimulating factor.

OBJECTIVE：To study the protective effects of butein on oxidative stress injury of PC12 cell and its effects on mitochondrial function. METHODS：Rats PC12 cells were divided into normal control group，model group，solvent control group（1 ‰ dimethyl sulfoxide），butein high，medium and low concentration groups（2，1，0.5 μmol/L）. The latter 4 groups were given relevant reagent/medicine for intervention；24 h later，other groups were given 100 mU/mL glucose oxidase to induce oxidant stress model except for normal control group. After 4 h culture，cell survival rate，apoptosis rate，the levels or activities of ROS，MDA，SOD，CAT，GSH-Px，ATP，IL-1β and TNF-α as well as the change of MMP were detected. RESULTS：Compared with normal control group，cell survival rate，the levels or activities of SOD，CAT，GSH-Px and ATP were all decreased significantly，and apoptotic rate，the content of ROS，the levels of MDA，IL-1β and TNF-α were all increased significantly（P＜0.05 or P＜0.01），while the MMP was decreased significantly. Compared with model group，above indexes of solvent control group had no significant change （P＞0.05），cell survival rates，the levels or activities of SOD （except for medium and low concentration groups），CAT，GSH-Px（except for medium and low concentration groups），ATP（except for low concentration group）were increased significantly in butein high，medium and low concentration groups，while apoptotic rates，the content of ROS，the levels of MDA，IL-1 β and TNF-α were decreased significantly（P＜0.05 or P＜0.01），while the MMP were increased significantly. CONCLUSIONS：Butein can increase the antioxidant enzyme activity， stabilize mitochondrial function， inhibit oxidative stress and inflammationthus， increase energy generation inhibiting neuronal cell apoptosis ultimately exerting a neuroprotective effect.

Objective:To investigate the influencing factors of hospitalization expenses in high-rate cases, and provide scientific basis for targeted cost control.Methods:The first page data of 79 929 discharged medical records of a tertiary hospital in Ningxia Hui Autonomous Region in 2018 were selected for DRG analysis and evaluation. The average total hospitalization expenses of the same DRG group in the same level and similar hospitals in Ningxia were taken as the benchmark cost to calculate the benchmarking ratio of each DRG group. GM grey correlation method was applied to analyze the correlation between each sub-item cost and the total hospitalization cost of each DRG group, and the logistic regression was used to analyze the influencing factors of high-rate cases.Results:There were 1 292 high-rate cases, accounting for 1.64% of 78 789 DRG-incorporated cases. The results of grey correlation analysis showed that among the 10 high-rate DRG groups, the correlation order of drug cost in 6 DRG groups was the first, and that of consumables cost was the first in 2 DRG groups; logistic regression results showed that age group( P=0.010), actual hospital stay( P<0.001), and mode of leaving hospital( P<0.001) were the influencing factors of high-rate cases. Conclusions:Drug costs, consumables costs, and length of stay have great influence on the hospitalization costs for high-rate cases, which should be paid particular attention to.

Objective:To explore the method of improving the accuracy of dose calculation of treatment plan in radiotherapy for patients with metal implants.Methods:A CT simulator with metal artifact reduction technique (MAR) was utilized to scan the CIRS intensity-modulated phantom with metal rods and 8 patients with steel nails implanted in the centrum for radiotherapy. Radiotherapy plans were designed using conventional CT images, MAR images and density-filled images. The dose calculation errors between single field and intensity-modulated radiotherapy (IMRT) plan were compared. The effect of mental implants and their artifacts on the irradiation dose of IMRT plan was evaluated.Results:In the conventional CT images of the phantom, when the incident path of the field failed to pass through the metal region, the dose calculation error for a single field was 3.85%, and the range of dose error for the field was 4.46%-74.11% when passing through the metal region. IMRT planning errors might exceed the clinically acceptable range when the incident path of the field passed through the metal region, and the errors tended to increase with the increase of dose weight of this field. After processing the images with density filling and artifact reduction techniques, the errors of the single field were 1.23% and 0.89%-4.73%, respectively, and the dose error of IMRT was 1.84%. The error of IMRT plan was 1.88% if density filling technique alone was employed to process the metal region. Due to the influence of metal implants and their artifacts, the minimum dose, average dose and prescription dose coverage actually received in the tumor target area were lower than IMRT plan results based on conventional CT images. The dosimetric difference of organs at risk was not statistically significant.Conclusions:In the radiotherapy plan based on conventional CT images, there may be a large dose calculation error when the incident path of field passes through the metal region. If the metal material is known, density filling of the metal region in the planning system can effectively improve the accuracy of dose calculation. Metal artifact reduction technique can significantly improve the image quality and further reduce dose calculation error, which should be a routine technique for CT machines equipped with this function to perform simulated localization of patients with metal implants.

Objective:To analyze the spatial-temporal distribution characteristics of human brucellosis (HB) in Ningxia Hui Autonomous Region (Ningxia) from 2012 to 2018 and the correlation between HB and the number of livestock stocks, so as to provide reference for the development of preventive measures.Methods:Data on the incidence of HB was collected from the Infectious Disease Report Information Management System of Ningxia, 2012 to 2018. Data related to HB incidence in Ningxia from 2012 to 2018 was then analyzed by global spatial autocorrelation and local spatial autocorrelation analysis methods through the geographic information system (GIS). SPSS (23.0) Spearman correlation was used to analyze the correlation between the incidence of HB and the number of cattle, sheep and pigs.Results:From 2012 to 2018, the incidence of HB showed an overall increase in Ningxia, with an annual growth in 2012-2015 but declined between 2015 and 2018. Results from the global autocorrelation analysis showed that the distribution of HB in the counties and districts of Ningxia appeared non-randomly, with Moran’s I value as positive in 2012, 2013 and 2016 indicating the distribution was positive in space. Through local autocorrelation analysis, results showed that "H-H" concentration area was mainly concentrated in central while the "L-L" concentration area was mainly in the northern part of Ningxia. As for the results from correlation analysis between HB and animal husbandry, it showed that the incidence of HB was positively correlated with the number of sheep in stock ( r=0.692, P=0.000). Conclusions:The epidemic situation of HB expressed different degrees of aggregation. Areas with high incidence were mostly concentrated in central Ningxia, and with certain degree of correlation with the number of sheep in stock. Corresponding measures should be taken to control the different aggregation situation. Programs on quarantine and immunization for sheep should also be strengthened.

Objective To reduce the risk of radiation-induced cardiac injury in patients with left breast cancer after breast-conserving surgery by multileaf collimator (MLC) shielding technique.Methods A total of 18 patients with left breast cancer after breast conserving surgery were selected to obtain 3DCT and 4DCT images at free breathing state.The target area was identified on the 3DCT image by registration with 4DCT images and to develop a hybrid intensity-modulated treatment plan (H_IMRT) and a heart sparing hybrid intensity-modulated treatment plan (HSH_IMRT) to introduce MLC shielding technology to reduce the cardiac exposure dose,and to perform dosimetry verification of the treatment plan by using the Compass verification system.The prescription dose was 50 Gy in 25 fractions.The dosimetry parameters of the target area and the organs at risk were compared between the two treatment plans and the dose verification result.Results The result of the treatment plan showed that compared with H_IMRT,the dose uniformity of the target area of HSH_IMRT was better,and the difference of conformability was not statistically significant (P＞0.05).The mean dose of the whole heart decreased by 23.67％ (t =13.693,P＜0.05) compared with the former.Dmax and D of other substructures of the heart were lower than the former.The result of dose verification showed that there was no statistically significant difference in uniformity and conformity between the two planned target doses (P＞ 0.05).The mean dose of the whole heart of HSH_IMRT was 24.88％ (t =13.782,P＜0.05) lower than that of H_IMRT,and except for the left ventricle and right ventricle,the Dmax of other heart substructures and D of all heart substructures decreased.Both the planned and the dose verification result showed that the V20 and the D of the affected lung were lower in HSH_IMRT.Conclusions Reasonable introduction of MLC shielding technology in H_IMRT can reduce the exposure dose of cardiac and further reduce the risk of radiation damage in heart.