Objectives:To investigate the imaging characteristics and incidence rate of nuchal ligament calci-fication in asymptomatic population.Methods:The clinical and imaging data of 318 asymptomatic volunteers were analyzed retrospectively,including the incidence,morphological classification,and segmental distribution of nuchal ligament calcification.The volunteers were divided into two groups based on the presence of nuchal ligament calcification,and differences in gender,age,body mass index(BMD,and lower cervical intervertebral parameters between the two groups were analyzed.Based on the Roussouly classification,differences in cervi-cothoracic parameters between the groups were analyzed.Finally,the correlation between the degree of nuchal ligament calcification and the aforementioned factors was studied to identify the risk factors for nuchal liga-ment calcification.Results:Among the 318 asymptomatic subjects,the incidence of nuchal ligament calcifica-tion was 23.27％.There were statistically significant differences in gender ratio,age,and BMI between the calcification of nuchal ligament group(ONL+)and non-calcification of nuchal ligament group(ONL-)(P＜0.001).The calcification of nuchal ligament was classified morphologically as follows:Local calcification 50.0％,con-tinuous calcification 27.0％,segmental calcification 7.0％,mixed calcification 9.0％and unclassified calcifica-tion 7.0％.The incidence of nuchal ligament calcification in each segment was as follows:C2/3 1.4％,C3/49.5％,C4/5 55.4％,C5/6 63.5％,and C6/7 18.9％.Compared with the ONL-group,the angular displacement(AD)and horizontal displacement(HD)of the ONL+group were significantly increased(P＜0.001).Based on the Roussouly classification,significant statistical differences in cervicothoracic parameters such as O-C2,C2-C7 SVA,and T1 slope(TS)were found between the ONL+group and the ONL-group(P＜0.05).Pearson correlation analysis showed that the degree of nuchal ligament calcification had a moderate correlation with AD,O-C2,and C2-C7 SVA,and a strong correlation with HD and TS.Multivariate logistic analysis revealed that HD was the most significant risk factor for nuchal ligament calcification,followed by O-C2,age,and AD.Conclusions:The incidence of nuchal ligament calcification was higher in asymptomatic men who were older and had a high body mass index.Cervicothoracic parameters(O-C2,C2-C7 SVA and TS)and segmental parameters(AD,HD)were significantly increased in the group of nuchal ligament calcification,and were correlated with the degree of nuchal ligament calcification.

Objective:To investigate the implementation status of sepsis hour-1 bundle strategy for patients with septic shock in emergency department.Methods:A total of 116 septic shock patients admitted to the emergency department from January 2020 to December 2020 were included in this prospective study, and the implementation of sepsis bundles and the clinical outcomes of patients were recorded.Results:Among 116 patients, 20 cases (17.2%) had lactic acid monitored within 1 h, 20 cases (17.2%) had blood culture before antibiotics, 82 cases (70.1%) received broad-spectrum antibiotics, 16 cases (13.8%) received fluid resuscitation ≥30 ml/kg, and 57 cases (49.1%) received vasoactive drugs during resuscitation. Finally, the sepsis hour-1 bundle strategy was fully implemented only in 13 cases (11.2%). Compared with the group with incomplete implementation of sepsis hour-1 bundle strategy, the volume of fluid recovery in the group with full implementation was significantly increased [33.7 (30.0,37.5) vs. 8.9(7.3,10.8) ml/kg, Z=-4.78, P<0.001], mean artery blood pressure significantly increased [70.0 (70.0,76.7) vs. 67.7 (61.7,76.7)mmHg(1 mmHg=0.133 kPa) , Z=-2.00, P<0.001], and lactic acid significantly decreased [3.0 (2.0,3.2) vs. 4.4 (3.7,7.2) mmol/L, Z=-2.76, P=0.006]. However, there were no significant differences in ICU mortality, in-hospital mortality and 28-day mortality between the two groups ( P>0.05). Conclusions:Septic shock patients in emergency department have poor compliance with the implementation of sepsis hour-1 bundle strategy, and relevant management training should be strengthened.

OBJECTIVE: To explore the cause of abortion and strategy of prenatal diagnosis for pregnant women with high risk for chromosomal abnormalities by using copy number variation sequencing (CNV-seq) and short tandem repeats (STR) analysis. METHODS: A total of 36 samples were collected, including amniotic fluid, abortion tissue, whole blood, chorionic villi and umbilical cord blood. CNV-seq and STR analysis were carried out to detect microdeletions, microduplications, chromosomal aneuploidies, mosaicisms and triploidies. RESULTS: Among all samples, 1 was detected with 4p15.1p16.3 and 14q11.1q22.1 duplication, 1 was detected with 19p13.3 deletion, 8 were detected with chromosomal aneuploidies, 4 were detected with mosaicisms, two were detected with triploidies. No definite pathogenic CNVs were detected in 20 samples, which yielded a positive detection rate of 44.44%. CONCLUSION As a high-throughput detection method, CNV-seq has the advantages of rapidity, simplicity and high accuracy. It may suit prenatal diagnosis and analysis of abortion factors in combination with STR analysis.
Abortion, Spontaneous/genetics* ; DNA Copy Number Variations ; Female ; Humans ; Karyotyping ; Microsatellite Repeats ; Pregnancy ; Prenatal Diagnosis

Objective:To understand the problems and countermeasures of information support for dentofacial deformities patients, so as to provide reference for optimizing the whole process of information support for orthognathic-orthodontics treatment.Methods:Using a descriptive research method, 10 orthognathic surgery and orthodontics specialists from a tertiary level A hospital were selected for semi-structured interviews in August and September, 2019 using the method of target sampling. The QSR Nvivo 12.0 software was used for analysis by adopting traditional content analysis.Results:According to the analysis, medical experts believed that the problems of information support in the whole treatment process of orthognathic-orthodontics treatment include the following three aspects: information content problems (incomplete information content, lack of "time" dimension, patient's psychological expectation and treatment outcome information asymmetry, lack of information for main caregivers), difficulties in information support (clinical workload, professional limitations, many key time nodes), existing network information problems (poor quality of network information, lack of pertinence of information content and the existing network resources were not effectively utilized); and three suggestions were put forward: customizing the treatment schedule of patients, developing diversified information support methods, optimizing patient treatment process.Conclusion:Medical staff should pay attention to the construction and improvement of the whole treatment information support content of dentofacial deformities patients, pay attention to the diversity of information support methods, optimize the patient treatment process, encourage the health care to cooperate with the homogenization management of the whole treatment information support, and explore the information support system suitable for the situation of dentofacial deformities patients in China.

Objective: To investigate the role of HIV-1 envelope protein gp120 in cognitive impairment induced by neuronal damage. Methods: Western blot and immunofluorescence assay were used to detect microglia activation, inflammatory factor expression and neuronal damage after gp120 treatment. Neuronal damage and neurocognitive performance in gp120-transgenic mice were evaluated using immunohistochemical staining and behavioral analysis, respectively. Results: In vivo and in vitro experiments showed that HIV-1 gp120 significantly induced the expression of caspase-1 and IL-1β, and indirectly caused neuronal synaptic shortening and neuronal damage (P<0.05). Compared with wild-type mice, gp120-transgenic mice showed significant cortical and hippocampal glial activation, neuronal loss, dendritic damage and neurocognitive disorders. Conclusions HIV-1 gp120 might cause neuronal damage through activating the release of inflammatory factor by microglia and involve in neurocognitive impairment.

Background: Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is a common critical illness in clinical practice. Early gastroscopic intervention may detect the bleeding lesion, and endoscopic treatment can be performed if necessary. Aims: To explore the value of ultra-early emergency gastroscopy (performed within 4 hours of bleeding) in patients with ANVUGIB. Methods: A total of 120 patients with ANVUGIB admitted from December 2019 to October 2020 at the Jinhua Hospital were recruited in this retrospective study. All patients received an emergency gastroscopy after admission. According to the timing of emergency gastroscopy, they were divided into three groups: ultra-early group (gastroscopy performed within 4 hours of bleeding), early group (gastroscopy performed within 4-24 hours of bleeding), and routine group (gastroscopy performed within 24-48 hours of bleeding). The detection rate of bleeding lesion and efficacy of endoscopic intervention were compared between the three groups. Results: The detection rate of bleeding lesion in ultra-early group was moderately higher than that in early group and routine group with no significant difference (94.6% vs. 89.7% and 86.4%, P>0.05). There were no significant differences in immediate hemostasis rate, rebleeding rate and mortality rate between the three groups (P>0.05). But the time of oral feeding, amount of blood transfusion, as well as the length and cost of hospital stay in ultra-early group were superior to those in early group and routine group (P<0.05). Conclusions: Ultra-early emergency gastroscopy within 4 hours of bleeding can increase the detection rate of bleeding lesion, accelerate the time of oral feeding, and reduce the amount of blood transfusion. It is beneficial for establishing definite diagnosis and may guide the treatment regimen in patients with ANVUGIB.

OBJECTIVE: To construct a HIV-1 gp120 transgenic mice (gp120 Tg) with vimentin (VIM) gene knockout. METHODS: Female HIV-1 gp120 Tg mice were mated to VIM heterozygote mice (F0). All the offspring mice were derived from these original founders so that both genotypes had the same mixed genetic background. The F1 mice were bred to generate of VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. PCR was performed for genotyping of the mice, and the expressions of VIM and gp120 in the brain tissues were examined using immunoblotting. RESULTS: The results of PCR showed the presence of the target bands in VIM, VIM, VIM/gp120 Tg and VIM/gp120 Tg mice. In VIM/gp120 Tg mice, gp120 expression was detected throughout the brain regions while no VIM expression was detected. CONCLUSIONS We generated gp120 transgenic mouse models with VIM gene knockout, which facilitate the exploration of the role of VIM in gp120-induced neurotoxicity.
Animals ; Brain ; Disease Models, Animal ; Female ; HIV Envelope Protein gp120 ; HIV-1 ; Mice ; Mice, Knockout ; Mice, Transgenic ; Vimentin

Objective To investigate the correlation between aryl hydrocarbon receptor (A hR) gene polymorphisms and haplotypes and susceptibility of ulcerative colitis (UC) .Methods From January 2010 to October 2017 ,at the Second Affiliated Hospital of Wenzhou Medical University ,the First Affiliated Hospital of Wenzhou Medical University , Central Hospital of Wenzhou City and Wenzhou People Hospital ,a total of 396 UC patients were recruited as the UC group .In the same period ,573 age-and gender-matched healthy individuals were taken as the healthy control group . Three single nucleotide polymorphisms (SNP) of A hR (rs10249788 ,rs2066853 ,rs2158041) were examined by modified multiple ligase detection reaction technique .The correlation between the differences in the frequency of each SNP mutant alleles ,genotypes and clinical pathological features of UC was analyzed by unconditional logistic regression analysis .Haploview 4 .2 software was applied to analyze the linkage disequilibrium (LD) . Results The frequency of mutant allele C and genotype TC+CC of AhR (rs10249788) of UC group were higher than those of the healthy control group (75 .00％ ,594/792 vs .69 .98％ ,802/1146 ;95 .45％ , 378/396 vs .91 .10％ ,522/573) ,the differences were statistically significant (odds ratio (OR)=1 .287 , 95％ confidence interval (CI) 1 .049 to 1 .579 , P=0 .016 ;OR=2 .052 ,95％ CI 1 .180 to 3 .568 , P=0 .011) .Compared with the patients with distal colitis ,the frequencies of mutant allele C and genotype TC +CC of AhR (rs10249788) were higher in the patients with extensive colitis (71 .34％ ,341/478 vs . 80 .57％ ,253/314;93 .31％ ,223/239 vs .98 .73％ ,155/157) ,and the differences were statistically significant (OR=1 .666 ,95％ CI 1 .183 to 2 .347 ,P=0 .003 ;OR=5 .561 ,95％ CI 1 .260 to 24 .530 ,P=0 .023) .The results of LD analysis indicated that rs10249788 and rs2066853 ,rs10249788 and rs2158041 , rs2066853 and rs2158041 were linked to each other (D′=0 .636 ,0 .430 and 0 .980 ;r2 =0 .270 ,0 .023 and 0 .177 ) . Compared with the healthy control group , the frequency of haplotype TAC of UC group decreased (20 .20％ ,231 .5/1146 .0 vs .16 .24％ ,128 .6/792 .0) ,however the frequency of haplotype CAC increased (14 .43％ , 165 .4/1146 .0 vs . 20 .47％ , 162 .1/792 .0 ) , and the differences were statistically significant (OR=0 .767 ,95％ CI 0 .605 to 0 .973 , P=0 .029 ;OR=1 .529 ,95％ CI 1 .204 to 1 .941 ,P<0 .01) .The results of further analysis demonstrated that the frequency of haplotype CGC was higher in patients with extensive colitis than that of patients with distal colitis (38 .69％ ,121 .5/314 .0 vs . 29 .48％ ,140 .9/478 .0) ,and the difference was statistically significant (OR=1 .511 ,95％ CI 1 .119 to 2 .040 ,P= 0 .007) ,while the frequency of haplotype TAC in patients with extensive colitis was lower than that of patients with distal colitis (12 .10％ , 38/314 .0 vs . 17 .55％ , 83 .9/478 .0 ) , and the difference was statistically significant (OR= 0 .646 ,95％ CI 0 .483 to 0 .983 , P= 0 .037) .Conclusion A hR (rs10249788) may be a potential locus affecting susceptibility to UC ,and synergistically influence the risk and the location of UC .

Objective To investigate the current status and existing problems in the implementation of stroke care continuity in China, and to collect relevant suggestions for solving these problems. Methods Focus group interviews were used, to survey thirty-six nursing managers and senior nurses in neurology departments or rehabilitation programs in 24 cities of 13 provinces. The interview team members presided over the meetings, with full-time staff taking notes and recordings, and the results of the interviews were summarized and organized in a timely manner after the interview. Results At present, most of the general hospitals surveyed are doing their best to continue supporting nursing care for patients discharged from hospitals in different forms following their rescue of the acute phase. However, they are faced with such challenges as insufficient nursing manpower, and discontinuity between different medical institutions, which result in oversimplified nursing care and fragmented care. Conclusions Stroke nursing practitioners are working on continuous nursing care, with quite some challenges as well. Nursing care continuity is an important step towards establishing and improving a scientific and rational grading nursing care system.

This study started with the comprehensive experimental research and practice of pre-ventive medicine. Taking the school of public health of China Medical University as an example, this paper introduced the ideas, principles, and experience of reform and implementation of comprehensive experimen-tal teaching. The methods of comprehensive experiments construction and implementation were introduced, such as subjects, application, basic training, implementation, writing, replying and score. In addition, the comprehensive experimental topics (such as classic experiment, new technology experiment, interesting ex-periment and fund project experiment et al), and basic training (such as literature searching, epidemiology and statistical analysis, laboratory safety and quality of experimental data, network sharing et al) were pre-sented in detail. It gave the evaluation that the comprehensive experimental teaching played an important role in the process of improving the quality of teaching and formed a unique preventive medicine experi-mental teaching system and talent training mode.