Objective:To explore the clinical features of acute diquat (DQ) poisoning, and further improve the awareness of acute DQ poisoning.Methods:A retrospective analysis was performed on the clinical data of patients with acute DQ poisoning diagnosed in the emergency department of the Second Hospital of Hebei Medical University from January 1, 2019 to December 31, 2021. The clinical data included age, gender, exposure routes, presence of pesticides (drugs) mixture poisoning, dosage of poison, the time from taking poisoning to admitting in the emergency department, clinical manifestations, laboratory data, treatment, hospital days, prognosis and survival days.Results:The number of cases who firstly complained of acute DQ poisoning in the past three years were 19 cases in 2019, 28 cases in 2020, and 51 cases in 2021. A total of 12 patients were excluded due to being diagnosed paraquat (PQ) poisoning by toxicology detection. Finally, 86 cases of acute DQ poisoning were included, including 80 cases of oral DQ poisoning, 1 case of intramuscular injection, 1 case of binocular contact and 4 cases of dermal exposure. In 80 cases of oral DQ poisoning, there were 70 cases of diquat poisoning alone (42 cases survived, 28 cases died) and 10 cases of pesticide mixture poisoning (6 cases survived, 4 cases died). The time from oral poisoning to admitting in the emergency department was 0.5-96.0 hours, with an average of (8.6±5.8) hours. The time of intramuscular injection poisoning to admitting in the emergency department was 3 hours. The time of dermal exposure to admitting in the emergency department was relatively long, with an average of 66.1 hours. The time from oral simple DQ poisoning to death was 12.0-108.0 hours, and the time from oral mixed DQ poisoning to death was 24.0-576.0 hours. A total of 70 patients with oral diquat poisoning alone presented various degrees of multiple organ injuries. All patients presented gastrointestinal symptoms such as nausea and vomiting. Renal injury and central nervous system injury were the most significant and closely related to the prognosis.Conclusions:Acute oral DQ poisoning can cause to multiple organ injuries, and the clinical manifestations are related to the dose of the poison. In severe cases, acute renal failure and refractory circulatory failure occur within 24 hours after poisoning, and severe central nervous system injury with disturbance of consciousness as the primary manifestation occurs within 36 hours, followed by multiple organ failure until death.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines

Objective: To understand the relationship between visual impairment and risk of all-cause mortality in the elderly aged 65 years and older in 8 longevity areas in China. Methods: The data of the elderly aged 65 years and older in the project in 2012 were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, including physical measurement and survival status, and a follow-up for survival outcomes were conducted in 2014 and 2017 respectively. Cox proportional hazard regression model was used to analyze the influence of visual impairment on mortality. Gender and age specific analysis was conducted. Results: A total of 1 736 elderly adults were included. A total of 943 deaths occurred during the 5-year follow-up period with a 5-year mortality rate of 54.3%. The 5-year mortality rate was 76.7% in the group with visual impairment, and 47.6% in the group without visual impairment (P<0.001). After adjusting for demographic information, life style and some disease factors, the risk of 5-year mortality in the group with visual impairment group was 1.30 times higher than that in the group without visual impairment (HR=1.30, 95%CI: 1.09-1.55). In the females, the risk for mortality in the group with visual impairment was 1.48 times higher than that in the group without visual impairment (HR=1.48, 95%CI:1.20-1.84). However, vision status was not associated with the risk for mortality in males (HR=1.02, 95%CI: 0.72-1.43). The risk for mortality in the group with visual impairment was 1.39 times higher than that in the group without visual impairment in the elderly aged over 90 years (HR=1.39, 95%CI: 1.13-1.70). Vision status was not associated with mortality risk in the elderly aged 65-79 years and 80-89 years (HR=1.37, 95%CI: 0.61-3.07; HR=0.95, 95%CI: 0.61-1.48). Conclusion In the elderly people in China, visual impairment is a risk factor for mortality.

Objective To observe the effects of melatonin on synaptic plasticity impaired by spinal cord injury in rats. Methods A total of 54 female Sprague-Dawley rats were divided into sham group (n=18), control group (n=18) and melatonin group (n=18). Spinal cord inju-ry model was established with modified Allen's method at T10 (10 g from 25 mm height). The number of neurons and the expression of the Nissl body were detected with immunofluorescence and Nissl staining. The expression of neurofilament-200 (NF-200), brain-derived neuro-trophic factors (BDNF), Synapsin I and growth-associated protein-43 (GAP-43) was detected with Western blotting. Results Seven days af-ter injury, the number of motoneurons, the expression of Nissl body in motoneurons, and the expression of BDNF, Synapsin I and GAP-43 decreased in the control group compared with those in the sham group, and they increased in the melatonin group compared with those in the control group. Conclusion Melatonin can repair the impaired synaptic plasticity, which might promote the functional recovery after spi-nal cord injury.

Background Neovascular glaucoma (NVG) is secondary to retinal ischemia and hypoxia.Iris fluorescein angiography (IFA) can be used for early detection of NVG,but it can not reflect the condition of retinal blood vessels comprehensively.IFA combined with fundus fluorescein angiography (FFA) can detect the condition of retina and iris neovascularization comprehensively,but its application on diabetic retinopathy(DR) with NVG was rare in China.Objective This study was to evaluate the clinical application of IFA combined with FFA in proliferative diabetic retinopathy (PDR) patients with NVG.Methods A retrospectively study was designed.One hundred and thirty-three eyes with PDR were enrolled in Henan Eye Hospital from February 2013 to January 2016,including 100 eyes with no iris diseases,21 eyes with rubeosis iridis,and 12 eyes with NVG.All eyes underwent ophthalmic examinations that included best-corrected visual acuity,intraocular pressure,slit lamp,IFA and FFA.The differences of IFA examination and slit lamp examination in the eyes with rubeosis iridis were compared and statistical analyzed by McNemar nonparametric test.Results In this study,100 eyes with no iris leakage were identified by IFA,32 eyes with panretinal photocoagulation (PRP) treatment history had no retinal neovascularization and 68 eyes had retinal neovascularization;21 rubeosis iridis eyes with iris leakage at pupillary border or on iris surface were observed at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images;12 NVG eyes were observed having iris neovascular leakage on iris surface at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images.The detection rate of IFA examination on rubeosis iridis was 100％ (21/21),which was higher than 71.43％ (15/21) of slit lamp examination,and there was a significant difference between the two detection methods (P =0.03).Conclusions IFA combined with FFA can detect PDR with rubeosis iridis early,and it is helpful to guide the treatment timely.

Objective To investigate the effects of flavone from Galium verum L (FGVL) on hydrogen peroxide induced oxidative injury in human umbilical vein endothelial cells (HUVEC),and explore related mechanisms.Methods HUVEC were divided into five groups:control group (1640 complete medium),injured group (HUVEC treated with 100 μmol/L hydrogen peroxide for 4 h),FGVL group (HUVEC treated with 12.5 mg/L FGVL (group F1),25.0 mg/L (group F2),50.0 mg/L (group F3) for 24 h before hydrogen peroxide).The nitric oxide content was measured by nitric acid reductase method.The 6-keto-Prostacyclin-F1α (6-keto-PGF1α),thromboxane B2 (TXB2),interleukin (IL)-6 and IL-22 were determined by ELISA.mRNA expression of phosphatidylinositol 3-kinase (PI3K),protein kinase B (Akt) and endothelial nitric oxide synthase (eNOS) was detected by RT-PCR.Protein expression of p-Akt (ser473) and p-eNOS (ser1177) was determined by Western blot.Cell apoptosis was observed with fluorescence microscope after Hoechst33258 staining.Results (1) The contents of nitric oxide were significantly lower in the injured group than in the control group ((34.11 ± 1.78) μmol/L vs.(74.81 ± 2.93) μmol/L,P ＜ 0.05),which was significantly increased in group F2 ((41.86 ±2.32) μmol/L) and group F3 ((62.79 ± 1.16) μmol/L) compared with injured group (both P ＜ 0.05).(2)The secretion level of 6-keto-PGF1α was significantly lower in the injured group ((44.84 ± 3.87) ng/L) than in the control group ((82.38 ± 3.98) ng/L,P ＜ 0.05),which was significantly increased in group F1 ((52.76 ± 1.78) ng/L),FGVL 2 group which was(56.58 ± 1.44) ng/L and FGVL 3 group which was (67.78 ± 2.02) ng/L than that of injured group(all P ＜ 0.05).The secretion level of TXB2 was significantly higher in the injured group ((43.37±3.96) ng/L) than in the control group ((25.56 ± 1.75) ng/L,P ＜0.05),which was significantly reduced group F2 group ((32.41 ±1.68) ng/L) and group F3 ((28.23 ± 2.15) ng/L) than that of injured group(both P ＜ 0.05).(3) The contents of IL-6 and IL-22 were significantly higher in the injured group ((539.74 ± 11.63) ng/L) and ((23.70 ± 3.05) ng/L,respectively) than in the control group ((288.67 ± 19.52) ng/L) and ((23.70 ± 3.05) ng/L,respectively,both P ＜ 0.05).The contents of IL-6 were significantly lower in group F1,F2 and F3 compared to that of injured group(all P ＜ 0.05).The contents of IL-22 were significantly lower in group F2 and F3 than that of injured group(both P ＜ 0.05).(4) The relative levels of PI3K mRNA and eNOS mRNA in injured group (0.68 ± 0.09 and 0.22 ± 0.03,respectively) were significantly lower compared to control group(0.81 ±0.12 and 0.63 ±0.11,respectively,bothP＜0.05),PI3KmRNAin group F2 (0.76 ±0.03) and group F3 (PI3K mRNA 0.83 ± 0.06) as well as eNOS mRNA in group F1 (0.37 ± 0.08),F2 (0.53 ± 0.04) and F3 (0.56 ± 0.09) than those of injured group(all P ＜ 0.05).The mRNA expression of Akt was similar among groups (P ＞ 0.05).(5) The relative levels of p-Akt (ser473) and p-eNOS (ser1177) in injured group (0.48 ± 0.05 and 0.23 ± 0.03,respectively) were significantly lower compared to control group (0.71 ± 0.12 and 0.66 ± 0.05,respectively,both P ＜0.05),which was up-regulated in group F1,F2 and F3 groups compared to injured group(all P ＜ 0.05).(6) The cell apoptosis rate in injured groups was significantly higher compared to control group which ((63.67 ± 11.37)％ vs.(4.67 ± 1.15)％,P ＜0.05) which was significantly reduced in group F1((43.33 ±4.16)％),F2((18.33 ±4.93)％) and F3((15.67 ±2.08)％) compared to injured group (all P ＜ 0.05).Conclusion The FGVL can reduce hydrogen peroxide induced oxidative injury in HUVEC by increasing the level of nitric oxide through PI3K/Akt/eNOS pathway.

Objective:To explore the effects of double circumferential fibrotomy(CF)in the improvement of periodontal attachment of the teeth with periodontal disease.Methods:22 migrated incisors of 4 adults were randomly assigned to one-time CF group (T1 )and double CF group(T2)by center line.Periapical intraoral radiographic examination was performed using paralleling technique at pre-and post-leveling-alignment stage of the teeth.Root length,crown-root ratio and the distance of CEJ-AC were measured.The periodontal in-dicators were also recorded during the orthodontic treatment.Data were statistically analysed by comparative t-test.Results:CEJ-AC and crown root ratio reduction was greater in T2 group than those in T1 group(P <0.01 ),but the periodontal indices did not show sig-nificant difference between the 2 groups(P >0.05).Conclusion:Double circumferential fibrotomy can improve periodontal attachment, reasonable orthodontic force does not lead to remarkable root resorption of the periodontitis inflicted teeth.

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.