ObjectiveTo analyze the changes in the degree of coordination of China's major epidemic prevention and control efforts before and after the outbreak of the Corona Virus Disease 2019 (COVID-19), so as to explore the impact of epidemic prevention and control measures on coordination dynamics. MethodsA total of 3 864 policy documents related to epidemic prevention and control from January 2000 to December 2020 across 31 provinces (autonomous regions, and municipalities) in China were systematically collected. Contents specific to collaborative and cooperative efforts were extracted, and the extent of interdepartmental coordination were quantified to assess the effectiveness of epidemic prevention and control efforts. Wilcoxon signed-rank test was adopted to statistically analyze the differences between the indicators before and after the epidemic. ResultsThe average overall coordination level for major epidemic prevention and control in 31 provinces (autonomous regions, and municipalities) increased from 43.06% to 97.62%, and the average coordination levels in the eastern, central, and western China soared from 42.29%, 37.50%, and 47.46%, to 98.81%, 96.20%, and 97.46%, respectively, with statistically significant differences (all P<0.05). In terms of department categorization, coordination levels in the professional departments and the key support departments peaked at 100.00%, while other support departments rose to 95.43%, with an increase of 77.15%, 181.85%, and 139.89%, respectively, exhibiting noteworthy statistically significant differences (all P<0.001). ConclusionThe scope of coordination departments of China’s major epidemic prevention and control exists a remarkable surge following the COVID-19 outbreak, notable heightened coordination is particularly observed among the key support departments. Future endeavors should prioritize the roles played by diverse departments in epidemic prevention and control, enhancing both the clarity of departmental responsibilities and the effectiveness of interdepartmental coordination.

Objective:To investigate effect of Galangin on inflammatory response in autoimmune thyroiditis(AIT)rats by regulating chemokine ligand 2(CCL2)/chemokine receptor 2(CCR2)pathway.Methods:A total of 84 rats were randomly grouped into control group,model group,Galangin low dose group,Galangin medium dose group,Galangin high dose group,selenium yeast tablet group,Galangin high-dose+rat CCL2 recombinant protein(rCCL2)group,with 12 rats in each group.Except for control group,AIT models were constructed in rats of all other groups.After successful modeling,medication was administered once a day for 8 weeks.ELISA was applied to detect levels of thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),free thyroxine(FT4),free triiodothyronine(FT3)in rats serum and TNF-α,IL-6 and IL-1β in thyroid tissue;HE staining for pathological changes in rat thyroid tissue and scoring of inflammation in thyroid tissue;qRT-PCR was applied to detect expressions of CCL2 and CCR2 mRNA in thyroid tissue;Western blot was applied to detect expressions of CCL2 and CCR2 proteins in thyroid tissue.Results:Com-pared with control group,pathological damage to thyroid tissue of rats in model group was severe,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05);com-pared with model group,pathological damage of thyroid tissue of rats in Galangin low dose group,Galangin medium dose group,Galangin high dose group and selenium yeast tablet group were reduced,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were decreased(P<0.05);compared with Galangin high dose group,pathological damage of thyroid tissue in Galangin high dose+rCCL2 group was aggravated,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05).Conclusion:Galangin may inhibit inflammatory response of AIT rats by inhibiting CCL2/CCR2 signaling pathway.

Objective Based on the limited time theory,taking tonsillectomy day operation as an example,the whole process nursing list of day operation was constructed,and its application effect was evaluated.Methods The nursing service list of tonsillectomy was constructed based on literature research,field observation and expert correspondence.A total of 197 patients who underwent tonsillectomy in the day ward of a tertiary A general hospital in Hangzhou,Zhejiang Province were selected.Among them,98 patients from April to June 2023 were taken as an experimental group and treated with the whole-process nursing list of daytime tonsillectomy constructed in this study,and 99 patients from January to March 2023 were taken as a control group and routine nursing was adopted.The anxiety degree,postoperative pain score,postoperative complication rate and patients'satisfaction with nursing service were compared between the 2 groups.Results Anxiety scores before operation and at discharge,pain scores at 6 h,12 h and 24 h after operation,and incidence of complications such as infection and gastrointestinal reaction within 14 days after operation in the experimental group were lower than those in the control group,with statistical significance(P＜0.05).The satisfaction of nursing service in the experimental group(99.40±0.69)score was significantly higher than that in the control group(90.36±1.04)score,and the difference was statistically significant(P＜0.001).Conclusion The use of tonsillectomy day whole-process nursing list can improve perioperative anxiety,relieve postoperative pain and reduce the incidence of postoperative complications,and improve patient satisfaction.

Objective:To evaluate the complications of complex intracranial aneurysms after intervention with flow-diverter (FD) devices.Methods:Sixty patients with complex intracranial aneurysms accepted FD devices in Department of Cerebrovascular Diseases, Second Affiliated Hospital of Guilin Medical University from July 2018 to June 2021 were chosen. Clinical and imaging data of these patients were retrospectively analyzed, and complications were recorded: procedure-related adverse events, early postprocedural complications, complications during follow-up, and covered branch occlusion.Results:A total of 61 FD devices (47 Pipeline Flex, 10 Tubridge, 4 Surpass Streamline) were implanted in 60 patients. Incidence of procedure-related adverse events was 8.3% (5/60), including 3 with incomplete stent apposition, 1 with intraoperative bleeding, 1 with aneurysm neck not covered by stent; incidence of early postprocedural complications was 6.7% (4/60), including 3 with hemorrhagic complication and 1 with ischemic complication. DSA follow-up ([22.7±16.8] months) was completed in 54 patients; aneurysm healed rate was 83.3% (45/54). First DSA follow-up 6 months after surgery showed that in-stent restenosis was 7.4% (4/54), of which 2 deteriorated to parent vessel occlusion at 2- and 3-year after procedure, respectively. A total of 78 branch arteries were covered by FD devices, and only 1 (1.3%, 1/78) demonstrated branch artery occlusion at last follow-up, without clinical symptoms.Conclusion:The complications of complex intracranial aneurysms after intervention with FD devices should be recognized; incomplete stent apposition is the main procedure-related adverse event, and hemorrhagic complication mainly appear in the early postprocedural period; in-stent restenosis should be vigilant during follow-up.

Glucagonoma is a rare neuroendocrine tumor of α cells of the pancreas. The tumor excessively secretes glucagon and causes glucagonoma syndrome.70%-90% of patients with glucagonoma will develop necrolytic migratory erythema (NME). We reported a patient of glucagonoma syndrome who was presented to the dermatology outpatient clinic with a 2-year-history of recurrent erythema and scaling on the skin migrating throughout the body. A skin biopsy was performed and resulting features matched with NME, whilst imaging examinations suggested a soft tissue density tumor present in the tail of the pancreas with somatostatin receptor expression and laboratory tests found an elevated levels of serum glucagon. After the diagnosis was confirmed, the patient was treated with surgical resection of the glucagonoma and the skin eruptions resolved rapidly in 4 days. Meanwhile, we reviewed relevant literature published in recent years and summarized its clinical characteristics in order to improve its understanding by clinicians, including clinical manifestations, laboratory and imaging examinations, diagnosis and treatments.

Objective:To analyze the feasibility, safety and clinical efficacy of laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes patients (BMI≤32.5 kg/m 2). Methods:The clinical data of 135 patients who underwent laparoscopic side-to-side jejunoileal anastomosis at our hospital from Jan 2018 to Oct 2018 were retrospectively analyzed. They were followed up for 12 months until the end of Oct 2019. SPSS software was used to compare patients′ fasting blood glucose, glycosylated hemoglobin, c-peptide, insulin, body weight, BMI with the values after 12 months of the surgery, and then evaluate factors affecting the prognosis.Results:135 patients successfully completed laparoscopic side-to-side jejunoileal anastomosis without conversion to open surgery. After 12 months of the operation, the patients′ fasting blood glucose was (5.80±0.18)mmol/L, glycosylated hemoglobin was 5.9%±0.4%, fasting c-peptide was(1.32±0.21) nmol/L, and fasting insulin was (42±54) mU/L ( t=10.654, 12.657, 11.214, 10.698, all P<0.05). The body weight was (72.4±9.9)kg, BMI was( 25.6±2.8)kg/m 2, and the difference was not statistically significant ( t=7.658, 6.958, P>0.05). In patients with preoperative glycosylated hemoglobin controlled below 8% and the duration of T2DM less than 10 years, the chances being cured was better than that of those with glycosylated hemoglobin>8% and the medical history >10 years. Conclusion:Laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes is effective, safe and reliable.

Objective: To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention. Methods: A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively. Results: Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P<0.05). Before intervention, the scores of Barthel index, upper limb motor function, lower limb motor function were (33.15±7.08), (22.88±4.42), (15.31±3.38) in the observation group, and (33.40±3.78), (22.26±5.03), (16.04±3.30) in the control group, however, those index mentioned above were (47.96±8.45). There was no significant difference in Barthel index, motor function scores between two groups pre-intervention (P>0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05). Conclusion Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Objective:To evaluate the rationality of medical order in oncology department of our hospital and analyze the intervention effect of clinical pharmacist.Methods:Totally 180 medical orders in oncology department of our hospital from January to June in 2013 were selected as the pre-intervention group,and those with the same number from January to June in 2014 were selected as the post-intervention group.The rationality of medical orders including drug selection,administration routes,usage and dosage was investigated and compared between the groups. Results:The unreasonable rate was 41.11% before the intervention and 8.33% after the intervention with statistically significant difference(P<0.05).The irrational drug use included inappropriate indications,usage and dosage,improper drug replacement and combination,and inappropriate adjuvant drug use.Conclusion:Irrational drug use in oncology department can be significantly reduced and the level of rational drug use can be improved through the intervention of clinical pharmacist.

OBJECTIVETo evaluate the association of colorectal adenoma with metabolic syndrome (MS) and relevant parameters.

METHODSClinical data of 289 subjects who underwent screening colonoscopy in the University of Hong Kong-Shenzhen Hospital from January 2014 to June 2015 were retrospectively analyzed, including 130 normal subjects (normal group) and 159 cases with colorectal adenoma confirmed by pathology(adenoma group). Levels of MS-associated parameters were compared between the two groups, and the association of metabolic diseases with colorectal adenoma was examined.

RESULTSThe gender, smoking and drinking habit, regular physical activity, family history of colorectal cancer, and consumption history of long-term non-steroidal anti-inflammatory drugs were not significantly different between two groups (all P>0.05). As compared to normal group, adenoma group had higher body mass index (BMI) [(23.5±3.2) kg/m(2) vs. (22.7±2.8) kg/m(2), t=1.97, P=0.050], larger abdominal circumference [(83.4±10.3) cm vs. (79.6±13.8) cm, t=2.46, P=0.015], higher serum high-density lipoprotein level [(1.3±0.3) mmol/L vs. (1.2±0.3) mmol/L, t=2.03, P=0.044], and higher serum cholesterol [(5.4±1.0) mmol/L vs. (5.0±1.1) mmol/L, t=2.39, P=0.018]. No significant difference was demonstrated in comparing hip circumference and waist-hip ratio, as well as serum fasting glucose and triglyceride(all P>0.05). Higher incidence of colorectal adenoma was found in subjects with MS [69.8%(37/53) vs. 1.7%(122/236), P=0.017], overweight or obesity [65.1% (56/86) vs. 50.7%(103/203), P=0.025], hypertension [67.3%(37/55) vs. 52.1%(122/234), P=0.046] and hypercholesterolemia [66.7%(64/96) vs. 49.2%(95/193), P=0.005].

CONCLUSIONSMetabolic syndrome increased the risk of developing colorectal adenoma. The mechanism may be related to higher serum cholesterol and high density lipoprotein, which may lead to the elevated catabolism of serum cholesterol. Screening colonoscopy should be performed for patients diagnosed as metabolic syndrome, especially for those with central obesity and hypercholesterolemia, thus early diagnosis and treatment of colorectal adenoma may be available.

Adenoma ; epidemiology ; Blood Glucose ; chemistry ; Body Mass Index ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms ; epidemiology ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertension ; epidemiology ; Mass Screening ; Metabolic Syndrome ; epidemiology ; Obesity ; epidemiology ; Overweight ; epidemiology ; Retrospective Studies ; Triglycerides ; blood