Moral Dilemma and Research on Coping Style of Frontline Nurses During the Outbreak of COVID -19 / 中国医学伦理学

【Objective:】 To understand the moral dilemma, coping style of frontline nurses and their correlation during the COVID -19. 【Methods:】 From March to April, 2021, 651 nurses working in designated hospitals for COVID -19 were selected by convenient sampling, and the Chinese version of Moral Distress Scale-Revised (MDS-R) and Chinese version of Coping Style Questionnaire (CSQ) were used for investigation. 【Results:】 Frontline nurses’ MDS-R score was 91.0, "value conflicts" was the moral dilemma with the highest frequency and intensity, more than half (51.0%) of the respondents had considered leaving their position because of moral dilemma. "Problem solving" and "seeking for help" were the major coping strategies adopted by the nurses. Nurses who directly provide medical services for COVID -19 patients, dissatisfied with hospital-related training and adopted negative coping strategies had higher moral dilemmas than other nurses. 【Conclusion:】 The moral dilemma of frontline nurses is at a high level during the period of epidemic prevention and control. Nursing managers should pay attention to guiding and helping nurses to establish positive coping styles and improve their ability to respond to major public health emergencies.

Diversity of root canal morphology in mandibular first premolars and its clinical strategies / 中华口腔医学杂志

It is a basic prerequisite for the successful completion of endodontic treatment to thoroughly understand the root canal space anatomy. With the development of dental devices in dentistry, the root canal morphology of the mandibular first premolars can be presented in more detail. Before conducting root canal therapy on the mandibular first premolar with complex root canal morphology, it should be necessary to evaluate the potential difficulties and risks for making an appropriate treatment plan. The present paper reviews the research progress on the diversities of root canal morphology in mandibular first premolars in recent years, and then makes technologic recommendations based on the morphology diversities.

Analysis of the genomic landscape of primary central nervous system lymphoma using whole-genome sequencing in Chinese patients / 医学前沿

Primary central nervous system lymphoma (PCNSL) is an uncommon non-Hodgkin's lymphoma with poor prognosis. This study aimed to depict the genetic landscape of Chinese PCNSLs. Whole-genome sequencing was performed on 68 newly diagnosed Chinese PCNSL samples, whose genomic characteristics and clinicopathologic features were also analyzed. Structural variations were identified in all patients with a mean of 349, which did not significantly influence prognosis. Copy loss occurred in all samples, while gains were detected in 77.9% of the samples. The high level of copy number variations was significantly associated with poor progression-free survival (PFS) and overall survival (OS). A total of 263 genes mutated in coding regions were identified, including 6 newly discovered genes (ROBO2, KMT2C, CXCR4, MYOM2, BCLAF1, and NRXN3) detected in ⩾ 10% of the cases. CD79B mutation was significantly associated with lower PFS, TMSB4X mutation and high expression of TMSB4X protein was associated with lower OS. A prognostic risk scoring system was also established for PCNSL, which included Karnofsky performance status and six mutated genes (BRD4, EBF1, BTG1, CCND3, STAG2, and TMSB4X). Collectively, this study comprehensively reveals the genomic landscape of newly diagnosed Chinese PCNSLs, thereby enriching the present understanding of the genetic mechanisms of PCNSL.

Composite B-cell and T-cell lymphomas: clinical, pathological, and molecular features of three cases and literature review / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Composite lymphoma (CL) involving B-cell lymphoma and T-cell lymphoma is extremely rare. Herein, we report three such cases using immunohistochemistry, flow cytometry, and the next-generation sequencing (NGS) to identify the pathological and molecular characteristics of CL. In the first case, the patient was admitted to hospital for generalized pruritic maculopapular rash over the whole body. An excisional biopsy of the skin lesions showed T-cell lymphoma. At the same time, the staging bone marrow (BM) biopsy revealed a diffuse large B-cell lymphoma (DLBCL). After R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) therapies, the patient produced a good response with substantial dissipation of the rashes and relief of skin. The other two patients were admitted to hospital due to lymphadenopathy and were diagnosed with DLBCL and follicular lymphoma (FL) after core needle biopsy of lymph nodes, BM biopsy, BM aspiration, and flow cytometry. Following R-CHOP and R-COP (rituximab, cyclophosphamide, vincristine, and prednisone) therapies, they achieved complete remission unconfirmed (CRu) and complete remission (CR). However, one or two years later, they suffered a relapse of lymphadenopathy. The shocking fact was that re-biopsy of lymphadenopathy revealed peripheral T-cell lymphoma (PTCL) and angioimmunoblastic T-cell lymphoma (AITL). NGS findings identified DNA methyltransferase 3a (DNMT3a), isocitrate dehydrogenase 2 (IDH2), Ras homolog gene family, member A (RHOA), splicing factor 3B subunit 1 (SF3B1), and tumor protein p53 (TP53) mutations. After immunochemotherapy, these patients achieved CRu and CR again. Nevertheless, they suffered a second relapse of T-cell lymphoma. Finally, they died due to progression of disease. We found that the occurrence of CL is associated with Epstein-Barr virus infection and DNMT3a, IDH2, and TP53 mutations, and the prognosis of the disease is closely related to the T-cell lymphoma components.

Establishment and validation of a nomogram model for detect the risk of anemia after chemotherapy for the triple-negative breast cancer patients with Fukangning / 国际中医中药杂志

Objective:To explore the risk factors analysis and validation of anemia after triple-negative breast cancer (TNBC) and risk prediction model, to provide reference for reducing the incidence of anemia after TNBC-NAC.Methods:Retrospectively, 316 female TNBC-NAC patients in the breast department of our hospital from January 2016 to July 2021 were selected as the study subjects (modeling set), and the condition of anemia after the last chemotherapy was set as the observation group. In addition, 98 breast cancer patients in 2022 were selected for validation. Multivariate Logistic regression was used to analyze the effect of Fukangning capsule on TNBC-NAC anemia. We established the risk nomogram prediction model and calibration curve of anemia after chemotherapy by using R software and conducted internal and external verification. Hosmer-Lemeshow test was used to evaluate the prediction deviation between the risk prediction value of the nomogram model and the actual observed value, and the ROC curve was used to evaluate the prediction effect of the model.Results:A total of 75 (23.73%) among 316 patients developed anemia. The results of multivariate Logistic regression analysis showed that menopause [ OR (95% CI)=26.739 (5.063-141.227)], RBC [ OR (95% CI)=0.168 (0.098-0.286)], Hb level [ OR (95% CI)=0.952 (0.929-0.976)], and pathological stage Ⅲ[ OR (95% CI)=4.182 (1.759-9.946)] were independent risk factors for anemia after TNBC-NAC ( P<0.05). The nomogram prediction model established based on the above factors. Hosmer-Lemeshow test results showed that the difference between the risk prediction value and the actual observed value is ( χ2=3.68, P=0.885). The correction curve approaches to the ideal curve and the average absolute error was 0.012. The area under the ROC curve was 0.945, 95% CI was 0.918-0.972, sensitivity was 0.921 and specificity was 0.853, suggesting that the model has good differentiation and calibration degree. The external validation results showed that the nomogram predicted anemia with sensitivity of 88.7%, spectificity of 85.45% and accuracy of 86.73%. Conclusion:Menopausal status, RBC, Hb level before chemotherapy and pathological stage are independent risk factors for anemia after taking TNBC-NAC. The nomogram prediction model based on the above indicators had good discrimination and calibration, and accurately predicted the possibility of anemia after TNBC-NAC.

Research progress on role of traditional Chinese medicine in hepatic fibrosis based on miRNA-mediated activation of NLRP3 inflammasome / 中国中药杂志

In recent years, liver fibrosis has become a hotspot in the field of liver diseases. MicroRNA(miRNA)-mediated Nod-like receptor pyrin domain containing 3(NLRP3) inflammasome activation is pivotal in the pathogenesis of liver fibrosis. The present study mainly discussed the role of miRNA-mediated NLRP3 inflammasome activation in the pathogenesis of liver fibrosis. Different miRNA molecules regulated liver fibrosis by mediating NLRP3 inflammasome activation, including miRNA-350-3 p(miR-350-3 p)/interleukin-6(IL-6)-mediated signal transducer and activator of transcription 3(STAT3)/c-myc signaling pathway, miR-148 a-induced autophagy and apoptosis of hepatic stellate cells via hedgehog signaling pathway, miR-155-mediated NLRP3 inflammasome by the negative feedback of the suppressor of cytokine signaling-1(SOCS-1), miR-181 a-mediated downstream NLRP3 inflammatory pathway activation through mitogen-activated protein kinase kinase(MEK)/extracellular signal-regulated kinase(ERK)/nuclear transcription factor κB(NF-κB) inflammatory pathway, miR-21-promoted expression of NF-κB and NLRP3 of RAW264.7 cells in mice by inhibiting tumor necrosis factor-α inducible protein 3(A20), and miR-20 b-promoted expression of IL-1β and IL-18 by activating NLRP3 signaling pathway. Additionally, the anti-liver fibrosis mechanism of different active components in Chinese medicines(such as Curcumae Rhizoma, Glycyrrhizae Radix et Rhizoma, Aurantii Fructus, Polygoni Cuspidati Rhizoma et Radix, Moutan Cortex, Paeoniae Radix Alba, Epimedii Folium, and Cinnamomi Cortex) was also explored based on the anti-liver fibrosis effect of miRNA-mediated NLRP3 inflammasome activation.

CHINA PH ARMACY Volume 33，Number 4，February 28，2022 Semimonthly Table of Contents Empirical study on the influential factors of the drug complaint and reportin g system in China / 中国药房

OBJECTIVE To improve the drug complaint and reporting system in China ，and to provide reference for improving the social multi-component governance level of the drug safety. METHODS Taking Guangdong province as an example ， literature review ，questionnaire survey ，structural equation model and other methods were used to analyze influential factors of the drug complaint and reporting system ，such as “Internet+”approach，drug quality ，specialized drug knowledge ，complaint and reporting procedures ，complaint and reporting methods ，complaint and reporting motivation ，governmental reward ，administrative review or litigation. RESULTS & CONCLUSIONS A total of 3 375 questionnaires were received ，all of which were valid ；the vast majority of respondents lived in Guangdong province. The results of the empirical analysis of the influential factors of drug complaint and reporting system showed that the path coefficients of “Internet + ”approach and specialized drug knowledge ， complaint and reporting procedures ，complaint and reporting methods were all greater than 0.9，indicating“Internet+”promoted the transformation of the way and behavior of complaint and reporting. It is suggested that the design of the drug complaint and reporting system should not only attract the public to participate in drug complaint and reporting ，but also cultivate the public ’s management capacity through the approach of internet ， standardize professional anti-counterfeiting behavior ， promote the institutional reform of “digital government ”，and appropriately adjust the work responsibilities of drug regulatory department ，so as to reduce the number of drug complaint and reporting in China ，and optimize the drug safety governance system.

Generation of Kidney Directed Differentiation Platform from Human Pluripotent Stem Cells / 中国生物化学与分子生物学报

Kidney is an essential organ in human body with multiple physiological functions. However, there is 10 % population worldwide with renal disease. It is urgent to generate a model which is more similar with kidney at structural and functional level to study renal disease. The rise of in vitro differentiation technology from pluripotent stem cells gives regeneration medicine and precise medicine new energy. This study mimics kidney development in vitro by inducing human pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) into kidney progenitor cells, and further forming nephrons, which is the structure and function unit in kidney. Human pluripotent stem cells were differentiated into primitive streak through activating WNT pathway while inhibiting TGF-(B signaling. Afterward, the primitive streak spontaneously differentiated into intermediate mesoderm. Then, we induced intermediate mesoderm cells into kidney progenitor cells through FGF pathway. The FACS analysis data indicated kidney progenitor cells were up to 51. 5%-61. 9% in total cell population. Immuno-stai-ning results showed these structures contained podocytes of glomerulus, proximal tubule, and distal tubule. This kidney differentiation protocol is stable, high-efficient, and well repeatable. This research provides a novel platform for early human kidney development study, kidney disease modeling, and drug screening.

Epidemic characteristics of student tuberculosis in Xuzhou, Jiangsu, 2016-2020 / 中国热带医学

@#Abstract: Objective　The tuberculosis data of students registered and reported in Xuzhou from 2016 to 2020 were analyzed to provide a basis for Xuzhou to formulate tuberculosis prevention and control measures in schools. Method　The epidemiological characteristics of tuberculosis among students in Xuzhou from 2016 to 2020 were analyzed based on the data from Tuberculosis Information Management System and Xuzhou Statistical Yearbook 2021. Results　From 2016 to 2020, a total of 574 student tuberculosis patients were registered in Xuzhou, with an annual average registration rate of 5.64/100 000. The reported incidence of tuberculosis among students in Xuzhou showed an increasing trend year by year (χ2trend=22.521, P<0.001). There were 365 males and 209 females, respectively, with a sex ratio of 1.75:1. The tuberculosis patients were mainly in the 15-19 years old group and 20-24 years old group. According to the statistical analysis by different levels of education, students from ordinary higher institutions accounted for 48.61% of the total number of confirmed cases, followed by senior high schools and secondary vocational schools, accounting for 20.91% and 14.46%, respectively. Preschool education had the lowest number of confirmed cases, accounting for 1.05%. There was significant difference in the reported incidence of tuberculosis among students at different educational levels (χ2=1 522.39, P<0.001). The highest incidence was reported in ordinary higher institutions, followed by senior high schools and secondary vocational schools, and the lowest incidence was reported in preschool education. Conclusion　Xuzhou city school tuberculosis epidemic integral is on the rise, we should further strengthen tuberculosis control work of school tuberculosis prevention and control measures of implementation in the future, at the same time to strengthen school tuberculosis prevention knowledge propaganda and standardize the schools for disposal of tuberculosis epidemic situation. We should also further strengthen the newborn matriculation examination and students absent from class because of illness monitoring work.

Logistic Regression Analysis of the Mechanism of Blunt Brain Injury Inference Based on CT Images / 法医学杂志

OBJECTIVES@#To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree.@*METHODS@#A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. χ2 test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected.@*RESULTS@#χ2 test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (P<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (P<0.05).@*CONCLUSIONS@#EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.

Reliability and Validity of the Chinese Version of the Lymphedema Quality of Life Questionnaire / 中国医学科学杂志(英文版)

Objective To study the reliability and validity of the Chinese version of the Lymphedema Quality of Life Questionnaire (LYMQOL) in lymphedema patients. Methods LYMQOL was translated into Chinese. The Chinese version of the LYMQOL was distributed with the official Wechat account "Lymphedema Channel" to lymphedema patients who were recruited from October 28

Analysis and Suggestions on the Development of Biomedical Industry in Guangdong-Hong Kong-Macao Greater Bay Area / 中国药房

OBJECTIVE：To provide reference for furthe r promoting the high-quality development of the biomedical industry in Guangdong-Hong Kong-Macao Greater Bay Area. METHODS ：Through summarizing the development status and development environment of the biomedical industry in the Guangdong-Hong Kong-Macao Greater Bay Area ，the construction experience of foreign advanced biomedical industrial park was introduced ，and the problems and challenges faced by the biomedical industry in the Guangdong-Hong Kong-Macao Greater Bay Area were sorted out so as to put forward relevant countermeasures and suggestions. RESULTS & CONCLUSIONS ：Guangdong-Hong Kong-Macao Greater Bay Area has received multiple policy support，which is conducive to the development of biomedical industry. The industrial chain is complete ，and the scale advantage of biological industry is showing day by day. Biological industry has achieved fruitful innovation achievement ，and its R&D investment is in the leading position in the country. The pharmaceutical manufacturing industry is developed and the total amount of medical resources is large. The financial advantages are obvious ，and institutional innovation is conducive to the development of biomedical industry. The process of internationalization takes the leading place ，which is conducive to continuously promoting foreign cooperation. However ，compared with foreign advanced biomedical industrial parks ，Guangdong-Hong Kong-Macao Greater Bay Area still has some deficiencies in management mode ，service mode and “industry-university-institute”cooperation. It also faces the following problems that the legal systems and industry norms of the three places need to be further connected ；there is a talent gap ；the industrial chain is not perfect ；the support for new drug R&D is insufficient ；the“industry-university-institute” cooperation needs to be strengthened ；the level of financial support needs to be improved. Accordingly ，it is recommended to break down institutional barriers ，and promote the connection between the legal system and industry norms ；innovate talent policies ，and continue to attract excellent R&D talents ；introduce leading companies ，and improve the industrial chain ；open up clinical trial channels and promote the transformation efficiency of scientific research achievements ；strengthen“industry-university-institute” cooperation，and promote the improvement of biomedical innovation ability ；make good use of financial support to help the rapid rise of biomedical industry enterprises ，so as to promote the high-quality development of biomedical industry in Guangdong-Hong Kong-Macao Greater Bay Area.

Different methods establish a rat model of morphine drug discrimination with a fixed ratio 10 / 药学学报

In this study, a rat morphine drug discrimination model with a fixed ratio (FR) of 10 (FR10) was established using different methods to explore which methods can shorten the modeling time and test the dose-response relationship and median effective dose (ED50) value. Animal welfare and experimental procedures are in accordance with the provision of the Animal Ethics Committee of Shanghai InnoStar Bio-tech Co., Ltd. Forty rats were initially shaped to press lever under a fixed-ratio schedule of food reinforcement. The animals that were successfully trained under a FR10 schedule of food reinforcement were divided into two groups, namely the single-lever + double-lever training group 1 and the double-lever training group 2. In each group, rats were trained to discriminate morphine at 5.6 mg·kg-1 from saline by the intraperitoneal route. After training, different doses of morphine were used to substitute for training dose of morphine, the dose-response curve for morphine were identified in rats, and the ED50 value was calculated. The results showed that, in food training phase: 34 rats successfully entered the discrimination training during food training; in discrimination training phase: 14 animals in group 1 met the discrimination training standard for the first time, which took about (40.71 ± 2.93) days, and there were 13 animals in group 2 that met the discrimination training criteria for the first time, and it took about (51.15 ± 2.55) days. It can be seen that the method of single-lever + double-lever training is better than single-lever training, and the difference is significant compared with group 1 (P ˂ 0.05); in generalization test phase: there are 17 rats completed morphine generalization test, and the percentages of morphine-lever responses produced by the generalization test of different doses of morphine (0, 0.1, 0.5, 1, 3, 5.6, and 10 mg·kg-1) were (9.56 ± 3.13) %, (9.01 ± 5.83) %, (13.82 ± 7.95) %, (29.04 ± 10.13) %, (41.70 ± 10.65) %, (85.36 ± 7.16) %, (94.56 ± 2.76) %, respectively. The results showed that the discriminative stimulative effect induced by morphine dose between 0-10 mg·kg-1 increased in a dose-dependent manner, producing a good dose-response curve, and the ED50 value of morphine was 4.74 mg·kg-1 by linear fitting. The above results showed that, the FR10 morphine drug discrimination model has been successfully established using different methods; the single-lever + double-lever training method is better than the single-lever training, and can relatively shorten the discrimination training cycle.

Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome / 中西医结合学报

OBJECTIVE@#The clinical symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) can be effectively improved by traditional Chinese medicine (TCM) treatment, based on the usage of specific therapies for different TCM syndromes. However, in the stage of diagnosis, the standard criteria for the classification of TCM syndrome were still deficient. Through serum metabolic profiling, this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes, which can assist in diagnosis of the disease.@*METHODS@#Serum samples were collected from healthy controls (30 cases), IBS-D patients with Liver-Stagnation and Spleen-Deficiency syndrome (LSSD, 30 cases), Yang Deficiency of Spleen and Kidney syndrome (YDSK, 11 cases) and Damp Abundance due to Spleen-Deficiency syndrome (DASD, 22 cases). Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. The potential biomarkers were screened by orthogonal partial least square-discriminate analysis, while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in MetaboAnalyst 4.0.@*RESULTS@#Overall, 34 potential biomarkers were identified in LSSD group, 36 in YDSK group and 31 in DASD group. And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D. Glycerophospholipid metabolism was disturbed significantly in IBS-D patients, which may play a role in IBS-D through inflammation. What's more, three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.@*CONCLUSION@#The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways, whose metabolism was disturbed differently among three TCM syndromes in IBS-D. Therefore, the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators, which can facilitate the TCM-syndrome objective classification of IBS-D.

One new cembranoid diterpene from gum resin of Boswellia carterii / 中国中药杂志

This study aims to study the chemical components from the gum resin of Boswellia carterii. Five cembranoid diterpenes were isolated from the gum resin of B. carterii by various of column chromatographies including silica gel, Sephadex LH-20, and semi-preparative HPLC. Their structures were identified on the basis of physicochemical properties, mass spectrometry(MS), nuclear magnetic resonance(NMR), Ultraviolet(UV) and infrared(IR) spectroscopic data. These compounds were identified as(1S,2E,4R,5S,7E,11E)-4-methoxy-5-hydroxycembrane(1),(1R~*,4R~*,5E,8E,12E,15E)-4-hydroxycembra-5,8,12,15-tetraene(2), cembrene A(3),(3S,4S,7R)-4-hydroxycembrane(4), and pavidolide D(5). Compound 1 was a new compound. Compounds 2, 4, and 5 were obtained from the gum resin of B. carterii for the first time. Compound 2 showed weak inhibition on the human liver cancer cell line HepG2.

Survey of Oncomelania hupensis in national schistosomiasis surveillance sites of Guangxi Zhuang Autonomous Region from 2015 to 2019 / 中国血吸虫病防治杂志

Objective To investigate the distribution characteristics of Oncomelania hupensis in Guangxi Zhuang Autonomous Region, so as to provide insights into the assessment of the risk of schistosomiasis transmission and the scientific formulation of the schistosomiasis surveillance strategy. Methods From 2015 to 2019, a total of 19 national schistosomiasis surveillance sites were assigned in Guangxi Zhuang Autonomous Region, including 4 fixed sites and 15 mobile sites. Snail survey was performed by means of systematic sampling in combination with environmental sampling, and the infection of Schistosoma japonicum was detected by the crushing method combined with loop-mediated isothermal amplification (LAMP) assay. Results From 2015 to 2019, snail habitats were detected at areas of 17 040 to 39 527 m2, including 6 214 m2 emerging snail habitats and 16 563 m2 re-emerging snail habitats. The overall mean density of living snails was 0.019 2 snails/0.1 m2 and the occurrence of frames with snails was 1.11% in the national schistosomiasis surveillance sites; however, no S. japonicum infection was identified in snails. The area of snail habitats increased by 121.46% in the national surveillance sites in 2019 as compared to that in 2015; however, 50.34% (Z = −0.422, P > 0.05) and 42.85% (χ2 = 130.41, P < 0.01) reductions were seen in the overall means density of living snails and the occurrence of frames with snails. All snail habitats were distributed in the 4 fixed surveillance sites, and were mainly found in ditches, paddy fields and dry lands, with weeds as the primary vegetation type. Conclusions There are still risk factors leading to re-emergent transmission of schistosomiasis in Guangxi Zhuang Autonomous Region, such as local snail spread, and the monitoring of schistosomiasis remains to be reinforced to further consolidate the achievements of schistosomiasis elimination in the region.

Comment and Suggestion on the Renewal Clause of the Drug Production License in the Newly Revised Measures for Supervision and Administration of Pharmaceutical Production / 中国药房

OBJECTIVE：To pr ovide reference for the relevant departments to further clarify the definition and applicable rules of drug production license renewal ，and strengthen the supervision and administration of drug production. METHODS ：Through comparative study ，literature study ，empirical study and the interpretation of new regulations ，from the definition of drug production license renewal ，combined with actual cases and grass-roots practice ，drug production license renewal in the Measures for Supervision and Administration of Pharmaceutical Production were comprehensively evaluated and analyzed in terms of the definition， existing problems and revision points . The relevent application suggestion was put forward. RESULTS & CONCLUSIONS：In terms of definition ，the renewal of the drug production license refers to the behavior of a drug manufacturer that needs to continue to engage in drug production activities after the expiration of the validity period ，and should apply to the original issuing authority to extend the validity period of the drug production administrative license at 6 months before the expiration of the validity period. In terms of the main problems ，there are some problems ，such as whether the administrative organ can accept the application submitted after the deadline is not clear ；the examination standard of the administrative organ to renew the drug production license is unreasonable ；the follow-up procedure of the license rule of the “deemed to agree to renew the license”mode is not standardized. The renewal of the drug production license in the newly revised Measures for the Supervision and Administration of Pharmaceutical Production no longer needs to be reviewed in accordance with the procedures and requirements of the drug manufacturer ，but in accordance with the principles of risk management ，which reflecting the principle of strengthening risk management and forming risk closed-loop ，defining the review standard of drug production license renewal ， optimizing the conditions and requirements of approval ，and improving the effectiveness of administrative license. In terms of application，it is suggested to clarify the time limit and validity of the acceptance and decision of drug production license renewal ， and grant administrative agencies with the discretion to accept the application for overdue renewal.

A new cadinane-type sesquiterpenoid from Commiphora myrrha / 药学学报

Five cadinane-type sesquiterpenoids were isolated from the n-hexane extract of Commiphora myrrha by using various chromatographic techniques, including silica gel, ODS and semi-preparative HPLC. Their structures were identified by physicochemical properties and spectroscopic data. These compounds were defined as (3S,4R)-3,9-dimethoxymyrrhone (1), 9-methoxymyrrhone (2), myrrhone (3), commiterpene B (4) and comosone Ⅱ (5). Compound 1 is a new compound, of which the absolute configuration was established by single crystal X-ray crystallographic analysis. Compound 5 is firstly isolated from the Commiphora genus.

Isolation and identification of Yersinia pestis phages from squirrels in Yunnan and their epidemiological significance / 中华地方病学杂志

Objective:To investigate whether the squirrels in Yunnan Province carried Yersinia pestis phages and their epidemiological significance. Methods:From 2015 to 2018, plague host animals were investigated in five of Yunnan plague foci and non-plague foci. The spleen, liver and intestinal specimens of the squirrels captured in the investigation were taken and stored at low temperature for later use. Intestinal specimens with PBS solution, were filtered by 0.22 μm and added to LB liquid medium containing 100 μl suspension of plague vaccine strain (EV76) and then oscillated in a constant temperature gas bath at 28 ℃ and 220 r/min for 18 to 24 h. The double-layer plate method was used to isolate and observe the growth of plaque. The morphology and structure of Yersinia pestis phages were observed under electron microscope. Meanwhile, spleen, liver and intestinal specimens were taken for detection of Yersinia pestis specific marker gene caf1. Results:A total of 10 squirrels were captured (8 Callosciurus erythraeus and 2 Dremomys pernyi), and four Yersinia pestis phages were isolated (2 in Callosciurus erythraeus and 2 in Dremomys pernyi). Two were isolated from non-plague foci (Yongshan County), two from house rats plague foci (Mile County and Xinping County), and none was isolated from wild radents plague foci (Jianchuan County and Eryuan County). By naked eye observation, two bacteriophages from the plague foci produced transparent plaques and grew well, while two bacteriophages from non-plague foci produced translucent plaques and with poor growth. By electron microscopy, these Yersinia pestis phages were of typical Myoviridae family, their head diameter was about 40 nm, muscle tail was about 120 nm, and tail filament cluster was slightly visible at the end of muscle tail. And all the 10 samples of squirrels were negative of plague-specific caf1 gene. Conclusions:The proportion of plague phages carried by Yunnan squirrels is relatively high. Although the detection of caf1 is negative. Squirrels may be a carrier of plague transmission due to the existence of Yersinia pestis phages.

Study on Main Changes of Counterfeit and Inferior Drugs ’Relevant Provisions in the Newly Revised Drug Administration Law and Their Impact on Law Enforcement / 中国药房

OBJECTIVE：To provide reference for further clarifying the definition of counterfeit and inferior drugs and law enforcement for revelent departments ，and guaranteeing the safety of drug use and legitimate right for the public. METHODS ： Through comparative research ，literature research and interpretation of the new law ，comprehensive analysis and research was conducted for the relevant provisions of counterfeit and inferior drugs in the newly revised Drug Administration Law in respect of the definition ，penalty rules and identification basis of counterfeit and inferior drugs. The challenges and impacts of these changes on drug law enforcement were put forward from the perspective of drug law enforcement practice. RESULTS & CONCLUSIONS ： In terms of definition ，the newly revised Drug Administration Law redefined the counterfeit and inferior drugs ，which was reduced from 15 cases before the amendment to 11 kinds，but the content was more abundant. It cancelled the concept of punishing counterfeit and inferior drugs ；increased the prohibition of the use of counterfeit and inferior drugs ；punished violation behavior of drug administration order not according to counterfeit and inferior drugs ；removed two items that being punished as counterfeit drugs；adjusted the definition of contaminated drugs from counterfeit drugs to inferior drugs ；clarified the definition of excipients. In terms of penalty provisions ，the provisions of legal liability for counterfeit and inferior drugs in the newly revised Drug Administration Law comprehensively used a variety of punishment measures ，greatly increased the amount of fine ；differentiated the situation of production ，wholesale and retail of inferior drugs ，and set different punishment ranges ；appropriately reduced the punishment range of producing and selling TCM decoction pieces that did not meet the drug standards ；increased the punishment for the violation of drug management order ，and the scope of punishment was similar to that of counterfeit and inferior @qq.com drugs. The “double penalty system ”was implemented for serious illegal acts and punished to individuals. The punishment for drug users who used counterfeit and inferior drugs was clarified. The situation of heavier punishment for producing and selling counterfeit and inferior drugs was increased ，and the first responsibility system and punitive compensation were added to protect the legitimate rights and interests of consumers. In terms of identification basis ，the newly revised Drug Administration Law had deleted the provisions that specific situation of quality inspection conclusion may not be specified ，and only provided the principle provisions. The challenges and impacts of the newly revised Drug Administration Law on law enforcement included how to understand the “ingredients”in the definition of counterfeit drugs；how to distinguish between deteriorated drugs and contaminated drugs ；how to investigate and deal with unauthorized acts ； whether drug inspection reports were required in all cases of counterfeit and inferior drugs ；how to understand the situation that did not affect the safety and effectiveness ，and connecting administrative law enforcement with criminal justice for counterfeit and inferior drugs ，etc. It is suggested to further strengthen the law popularization ，and introduce the interpretation of the newly revised Drug Administration Law as soon as possible ，clarify the legislative intent ，and guide the grassroots law enforcement ；issue Amendment Ⅺ to the Criminal Law of the People ’s Republic of China as soon as possible ，increase the charges of illegal acts against the order of drug administration ，do a good job in connecting administrative law enforcement with criminal justice and crack down on the illegal and criminal acts in the field of drugs ，and further promote the administration according to law.