Study on extraction technology of Sophora flavescens-Phellodendron chinense drug pair / 中国药房

OBJECTIVE To study the extraction technology of Sophora flavescens-Phellodendron chinense drug pair and provide a reference for the development of new drugs for the treatment of anorectal diseases. METHODS Using the contents of total alkaloids of S. flavescens （matrine+oxymatrine）， berberine hydrochloride and total flavonoid， and extract yield as evaluation indicators， analytic hierarchy process-entropy weight method was used to calculate the weight coefficient of each indicator， and was combined with Box-Behnken design-response surface method to study the extraction technology of S. flavescens-P. chinense drug pair and verify it. RESULTS The optimal extraction technology of S. flavescens-P. chinense drug pair was immersed in 12-fold amount of 58% ethanol for 30 minutes and extracted twice， each time for 120 minutes. The relative error between the verification experimental results and the predicted value was 1.88%. CONCLUSIONS The obtained extraction technology is stable and feasible and can provide reference for the application of S. flavescens-P. chinense drug pair and development of new drugs.

Effect of volatile oil of Ligusticum chuanxiong on transdermal properties and cytotoxicity of triptolide in vitro / 中国药房

OBJECTIVE To explore the effect of volatile oil of Ligusticum chuanxiong on the transdermal properties and cytotoxicity of triptolide in vitro. METHODS The chemical constituents of the volatile oil of L. chuanxiong were analyzed by gas chromatography-mass spectrometry. The lower abdominal skin of KM mice was separated and divided into triptolide group， triptolide in compatibility with volatile oil of L. chuanxiong groups at 1∶10， 1∶50， 1∶100 （hereinafter referred to as “compatibility 1∶10”“compatibility 1∶50”“compatibility 1∶100” groups）. After the skin of mice in each group was fully exposed to 0.2 g of the corresponding cream for 24 h， the cumulative transdermal dose （Qn） of triptolide in the receiving solution of each group was determined by high-performance liquid chromatography， and the transdermal absorption rate （Jss） was calculated. Human immortalized keratinocytes （HaCat） were used as a model， the CCK-8 method was used to detect the cell survival rate of different concentrations of the volatile oil of L. chuanxiong and triptolide before and after compatibility. RESULTS A total of 62 chemical constituents of the volatile oil of L. chuanxiong were identified， including Z-ligustilide， senkyunolide， and β-selinene. The Qn （P＜ 0.01） and Jss of triptolide increased within 24 h in the compatibility 1∶10 and 1∶50 groups， while the Qn （P＜0.05） and Jss decreased in the compatibility 1∶100 group as compared with the triptolide group. Compared with the triptolide group， the cell survival rate of HaCat was significantly increased in the compatibility 1∶10 and 1∶50 groups when the triptolide concentrations were 36， 72 and 144 ng/mL （P＜0.05 or P＜0.01）； while the cell survival rate of HaCat was decreased in the compatibility 1∶100 group， but the difference was not statistically significant （P＞0.05）. CONCLUSIONS When the compatibility ratio of triptolide and volatile oil of L. chuanxiong was 1∶10 or 1∶50， it can promote the transdermal absorption of triptolide and reduce the cytotoxicity of triptolide to HaCat.

The value of multimodal functional magnetic resonance imaging in differentiating p53abn from p53wt endometrial carcinoma.

BACKGROUND: Endometrial carcinoma (EC) is the sixth most common cancer in women. P53 gene expression in patients with endometrial cancer can predict the efficacy and prognosis of patients with neoadjuvant therapy. PURPOSE: To explore the value of multimodal magnetic resonance imaging (MRI) in differentiating p53 abnormal (p53abn) from p53 wild-type (p53wt) EC. MATERIAL AND METHODS: Data from 47 EC patients, including 14 p53abn cases and 33 p53wt cases, were retrospectively analyzed. The preoperative MRI sequences included amide proton transfer weighted (APTw) imaging, T2 mapping, mDIXON-Quant imaging and diffusion-weighted imaging (DWI). After post-processing, APT, T2, transverse relaxation rate (R2*), fat fraction (FF) and apparent diffusion coefficient (ADC) maps were obtained. The APT, T2, R2*, FF and ADC values for lesions of the two groups of cases were measured by two observers who were blind to the pathological data. RESULTS: The APT value and R2* value in the p53abn group were higher than those in the p53wt group, while the ADC value was lower (all P < 0.05). There was no statistically significant difference in T2 value and FF value between the two groups (all P > 0.05). The area under curve of APT, R2*, ADC and combined APT + R2*+ADC values for identification of p53abn and p53wt EC were 0.739, 0.689, 0.718 and 0.820, respectively (all P > 0.05). CONCLUSION: APTw, mDIXON-Quant and DWI techniques can be usedfor quantitative identification of p53abn and p53wt EC. The multimodal MRI provides a new way for preoperative quantitative evaluation of EC molecular typing, which has certain clinical application value.

Mechanism research status of daidzein in the prevention and treatment of osteoporosis through estrogen-like effect / 中国药房

Osteoporosis， as a systemic bone disease with high incidence rate and high disability rate， has become a research hotspot in recent years. The daidzein in soybean isoflavones can bind with estrogen receptors， simulating the prevention and treatment of osteoporosis with estrogen-like effect. Its mechanism of action includes promoting osteoblast formation and differentiation by activating the Wnt signaling pathway， increasing bone density， and improving bone tissue health； inhibiting osteoclast differentiation and slowing down bone resorption by reducing receptor activator of nuclear factors κB ligand/ osteoprotegerin ratio， downregulating the expression of macrophage colony-stimulating factor （M-CSF）； collaborating antioxidant and immune regulation to achieve the goal of preventing and treating osteoporosis. In addition， different doses of daidzein have different effects on bone density and osteoporosis， which may be related to factors such as study design， sample selection， and individual differences.

Consistency study of FRACTURE sequence and CT in evaluating bone changes of knee and ankle / 中华放射学杂志

Objective:To explore the consistency of MRI fast field echo resembling a CT using restricted echo-spacing (FRACTURE) and CT in the evaluation of knee and ankle bone changes.Methods:From November 2020 to November 2021, seventeen patients who underwent CT and MRI FRACTURE examinations of knee joint or ankle joint in the First Affiliated Hospital of Dalian Medical University were retrospectively collected, including 14 patients with knee joint examinations and 3 patients with ankle joint examinations. According to the number of joint components, 80 components were included, including 14 for femur and patella, 17 for tibia and fibula, and 3 for talus, scaphoid, medial cuneiform, medial cuneiform, lateral cuneiform and calcaneus, respectively. The fracture, hyperosteogeny, and bone destruction of the joint bones were evaluated by two observers using CT and FRACTURE images, respectively. Kappa test was used to analyze the consistency of CT and FRACTURE images between observers in the evaluation of joint bone lesions.Results:The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by CT and FRACTURE images were 0.925 (0.823-1.027), 0.905 (0.799-1.011) and 0.895(0.752-1.038) respectively for observer 1, and were 0.963 (0.892-1.034), 0.933 (0.843-1.023) and 0.886 (0.731-1.041) respectively for observer 2. The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by observers 1 and 2 via CT images were 1.000 (1.000-1.000), 0.937(0.851-1.023) and 0.945 (0.839-1.051) respectively, and that by FRACTURE images were 0.962 (0.888-1.036), 0.966 (0.899-1.033) and 0.836 (0.656-1.016) respectively.Conclusion:For the evaluation of fracture, hyperosteogeny, and bone destruction of knee joint and ankle joint, MRI FRACTURE sequence is highly consistent with CT.

Epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 / 预防医学

Objective@#To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases.@*Methods@#The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed.@*Results@#Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively.@*Conclusions@#The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.

Epidemiological characteristics of varicella in schools of Yunnan Province in 2018 - 2020 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of school varicella and varicella public health emergency event (PHEE) in Yunnan Province, and to provide a scientific basis for the prevention and control of varicella in schools. Methods The descriptive epidemiological method was used to analyze the reported PHEE of varicella in students and varicella in schools in Yunnan Province from 2018 to 2020. Results From 2018 to 2020, a total of 69,391 cases of varicella were reported in students in Yunnan Province, accounting for 71.48% (69 391 / 97 080) of the total cases in the province, and the annual average reported incidence rate was 255.56/100 000 (69 391/27.1522 million). The time distribution of the incidence showed double peaks, which were from May to July (26.48%) and October to January of the following year (53.88%). The incidence rates of different schools from high to low were 301.74/100 000 for primary schools (34 816/11.538 3 million), 250.43/100 000 for kindergarten (11 526/4.6024 million), 202.74/100 000 for middle school (16 779/8.276 1 million), and 119.07/100 000 for others (3 257/2.735 4 million). The age distribution was mainly concentrated in 5-9 years old, accounting for 39.81% (27 625/69 391). Varicella PHEE accounted for 25.64% (180/702）of the province's PHEE in the same period, school varicella PHEE accounted for 100% of varicella PHEE, and the attack rate was 3.38% (6 566/194 260). The sources of reported varicella PHEE were hospitals 45.40% (58/123), epidemic analysis 36.78% (44/123), schools 13.22% (15/123), and others 4.60% (6/123). Conclusion The incidence of varicella in schools in Yunnan Province is high, which is harmful to students. PHEE reported in rural schools are relatively lagging behind. On the basis of doing two doses of varicella vaccination, emergency prevention should be focused on epidemic seasons, lower grade schools and rural schools. The source of infection shall be controlled and managed in time to prevent the outbreak of the epidemic. It is recommended that varicella should be included in the management of Class C infectious diseases.

Knowledge, attitude and practice about myopia prevention and control among young children s parents in Guangzhou City / 中国学校卫生

Objective@#To understand the status and associated factors of knowledge, attitude and practice (KAP) about myopia prevention and control among young children s parents in Guangzhou, so as to provide reference for family health education on myopia prevention and control.@*Methods@#During January to February 2023, 4 584 parents of children from kindergarten and primary school (grade 1-3) were recruited. Two to three kindergartens and 2 primary schools were selected from each of the 3 urban districts and 2 suburb districts of Guangzhou by stratified cluster random sampling method. Parents of children were administered with online questionnaire survey on KAP about myopia prevention and control. Descriptive analyses and multivariate Logistic regression models were used.@*Results@#The proportion of parents reaching standard of KAP about myopia prevention and control was 61.54%, the knowledge awareness rate was 57.30%, the positive attitude holding rate was 76.98% and the health practice formation rate was 63.31 %. Internet (70.35%) and lectures on school health education/health education materials (66.14%) were the most common ways for obtaining knowledge for parents. Multivariate Logistic regression analysis showed that urban area, higher education ( college /undergraduate or above), annual household income 50 000-90 000, 100 000-290 000, 300 000-490 000, 500 000- 590 000 , and ≥600 000 Yuan, being aware of vision status (normal/poor) of their children, one or both parents with myopia, both parents with non myopia, acquiring knowledge by multi ways(2, 3, ≥4) were associated with higher KAP about myopia prev ention and control ( OR =1.23, 1.34, 1.36, 1.25，1.49, 1.93, 2.34, 1.64, 1.66, 1.89, 3.48, 3.09, 2.42, 1.65, 2.29, 3.22, P ＜ 0.05).@*Conclusion@#Knowledge and practice about myopia prevention and control among young children s parents in Guangzhou are insufficient, yet the attitude was satisfactory. It is necessary to carry out targeted education for parents, especially those living in suburb area, with low education and income level.

Analysis of teaching difficulties in the chapter of antigen in Medical Immunology and teaching strategy / 细胞与分子免疫学杂志

The concept of "ntigen"is a relative one. The narrow concept of it condenses the process of activation of adaptive immune response and re-recognition of the same antigen, revealing the protective mechanism of vaccines with great significance for research and development of vaccines. However, the narrow concept involves adaptive immune system members: B cells, T cells and their effector products, which is difficult for beginners to understand the inherent meaning. Meanwhile, antigen classification fully summarizes the immune response process, so a variety of classification approach increases the difficulty in learning. Our teaching team analyzes the difficulties of this chapter in depth, and we implements the strategy that takes antibody structure and function as the breakthrough point and simplified adaptive immune response process as the core in teaching. A mind map that includes the main contents of this chapter is made during the process, which promotes the effectiveness of classroom teaching greatly.

CD226, TIGIT and CD96 regulate NK cell function and participate in anti-tumor immunity / 细胞与分子免疫学杂志

CD226 is an activated receptor on the surface of natural killer (NK) cells. It competes with TIGIT and CD96 to bind to ligands such as CD155 on the surface of tumor cells and mediates the killing function of NK cells. Although TIGIT and CD96 have other binding ligands in the tumor microenvironment, they compete to bind CD115 ligands with higher affinity and inhibit the activity of NK cells, which allows tumor cells to evade killing. Therefore, studying the expression patterns of these three NK cell surface receptors in different tumors and monitoring their binding ability with ligands will help us to explore new tumor treatment strategies. This article reviews the role and mechanism of CD226, TIGIT, CD96 and other NK cell receptor molecules in regulating NK cell function in anti-tumor immune response.

Analysis of teaching environment of primary and middle schools in Zhengzhou City from 2014 to 2018 / 中国学校卫生

Objective@#To understand the changing trend of the teaching environment of the elementary and secondary schools in Zhengzhou, and to provide data for further improving the teaching environment of the elementary and secondary schools.@*Methods@#A survey of teaching facilities and teaching aids in 534 secondary and primary schools in Zhengzhou was conducted from 2014 to 2018 by using a stratified random sampling method.@*Results@#Teaching facilities: the qualified rate of the railings in the outer corridor of the teaching building was 88.8% (474), the qualified rate of classroom lighting was 79.6% (425), the qualified rate of the light desk distance was 82.8% (442), and the qualified rate of black plate lights 86.1% (460), the qualified rate of each year was statistically significant ( χ 2=9.97, 23.74, 80.10, 53.33, P <0.05); the qualified rate of classroom area per capita was 52.8% (282), the qualified rate of the outer corridor width of the teaching building was 64.0% (342), the qualified rate of each year showed no statistical difference( χ 2=7.38, 8.71, P >0.05). Teaching ancillary facilities: the proportion of centralized water supply was 65.0% (347), toilet with hand washing facilities was 81.6% (436), these two indicators showed an increasing trend, hand washing facilities in campus was 70.6% (377), showed a decreasing trend, the rate of each year differed significantly( χ 2=88.62, 42.71 , 123.53, P <0.05).@*Conclusion@#The overall situation of teaching environment in Zhengzhou primary and secondary schools is relatively good, the qualified rate of most indicators of teaching facilities increased from 2014 to 2018. However, there are still some indicators to be strengthened.

Sequential treatment of initially diagnosed systemic multiple metastases advanced prostate cancer / 中华泌尿外科杂志

sequential treatment of advanced prostate cancer is a current research hotspot. One patient with advanced prostate cancer with multiple metastases at initial diagnosis in our institution was sequentially treated with endocrine, abiraterone, polymerase inhibitor, and enzalutamide with an overall survival of 35 months.

Clinical characteristics of pulmonary arteriovenous fistula related ischemic stroke / 中华神经科杂志

Objective:To investigate the clinical characteristics, treatments and prognosis of pulmonary arteriovenous fistula (PAVF) related ischemic stroke, as well as summarize the diagnosis and treatment process to screen and confirm PAVF related ischemic stroke.Methods:The clinical data of six PAVF related ischemic stroke patients in the First Affiliated Hospital of Fujian Medical University from January 2015 to January 2019, including clinical manifestations, brain magnetic resonance imaging, risk of paradoxical embolism (RoPE) score, contrast-enhanced transcranial Doppler (cTCD), contrast transesophageal echocardiography (cTEE), chest CT and pulmonary arteriography, were analyzed. PAVF patients were treated with interventional catheter embolization or conservative medication. All patients were followed up for 1.5 to 5.5 years.Results:All the six PAVF related ischemic stroke patients were young and middle-aged. The ratio of men to women was 1∶2. RoPE scores ranged from 6 to 7 points. Recurrent stroke was seen in five patients, and only one patient had primary stroke. Both anterior and posterior cerebral circulation could be involved. Hereditary hemorrhagic telangiectasia (HHT) was common in PAVF patients. Of the six patients, two had definite HHT with PAVF, two had suspicious HHT with PAVF, and the other two had sporadic PAVF. In all the six cases, a grade Ⅳright-to-left shunt (RLS) was observed on cTCD, and a mass of delayed microbubbles in the left atrium appeared on cTEE. One patient was diagnosed with patent foramen ovale (PFO). Lung enhanced CT was applied in all the patients. In three cases, PAVF was found located in left lower lobe. And in other three cases, lesions were located in left upper lobe, right lower lobe and right middle lung, separately. All cases were confirmed with simple type PAVF. Transcatheter embolization was performed to resolve PAVF in five patients. Of five post-operative patients, four cases showed no sign of RLS on cTCD. One patient combined with PFO still remained a small amount of potential RLS after embolization. One patient chose aspirin for conservative medication. All patients had no recurrence of ischemic stroke during the 1.5 to 5.5-year follow-up.Conclusions:PAVF related ischemic stroke patients have a high recurrence rate of ischemic stroke. PAVF related ischemic stroke has no specific brain imaging characteristics. cTCD is recommended for cryptogenic stroke patients with a high RoPE score (≥ 6 points) to detect RLS. If a patient turns out to be positive for RLS, cTEE could help differentiate intracardiac shunt from extracardiac shunt. For patients with cTEE suggesting extracardiac shunt, lung enhanced CT scan is necessary to confirm PAVF diagnosis. Patients who are diagnosed as PAVF can choose transcatheter embolization or surgical resection. cTCD could be used to evaluate the treatment effect.

Impact of age on the clinical outcome of sleeve gastrectomy / 国际外科学杂志

Objective:To compare the effect of age on clinical outcome of laparoscopic sleeve gastrectomy (LSG) in the obese patients.Methods:A total of 113 patients who underwent LSG due to obesity and metabolic disorders between 2013 and 2018 at Fudan University Pudong Hospital, and completed the scheduled follow-up (1, 3, 6, and 12 months after surgery) were included for the retrospective analysis. The patients were divided into three groups based upon pre-operative age, including 15 to 30 year-old group ( n=58), 31 to 45 year-old group ( n=32), and 45 to 65 year-old group ( n=23). The body weight related parameters, glycemic and metabolic related parameters, lipid panel as well as arterial blood pressure were compared at pre-operative baseline, 1, 3, 6, and 12 months after surgery. The quantitative data were analyzed by repeated measurement ANOVA, and the P value was corrected by Bonferroni method. And the categorical variables were analyzed by chi square test. Results:The preoperative baseline data showed that with the increase of age, the preoperative body mass index gradually decreased, which were (40.1±5.9) kg/m 2, (37.1±6.6) kg/m 2 and (35.3±7.4) kg/m 2 in 16 to 30, 31 to 45 and 46 to 65 year-old groups, respectively. Otherwise, other metabolic related parameters were comparable. At 12 months after LSG, there was no significant difference in the amount of weight loss among the groups, but the percentage of total weight loss (% TWL) and the percentage of total BMI loss (%TBMIL) decreased significantly with age increasing. The %TBMIL in 16 to 30, 31 to 45 and 46 to 65 year-old groups were 32.3±7.5%, 28.4±8.4% ( P<005 compared with 16 to 30 year-old group) and 25.7±8.2% (compared with 16 to 30 year-old group P<0.001), respectively. In the patients with preoperative HbA1c>7%, HbA1c reduction in the three groups at 12 months after operation were 3.20% (compared with 46-65 year-old group P<0.001), 2.64% (compared with 46-65 year-old group P<0.05) and 1.34%, respectively. The proportions of patients with HbA1c < 6.5% were 95.8%, 88.9% and 50.0%, respectively. LDL, triglyceride and arterial blood pressure in all groups decreased and HDL increased rapidly within 3 months after operation, but there was no significant difference among the three groups. Conclusions:The improvement of blood glucose metabolism and the remission rate of type 2 diabetes mellitus (T2DM) in the patients with older age were worse than those in the younger patients, and the T2DM in the younger patients tends to obtain better clinical remission after LSG; in terms of weight loss, with the increase of age, %TWL and %TBMIL also showed a decreasing trend; however, the improvement of blood lipid and blood pressure after LSG was not affected by the factor of age. This study implies that patients who meet the indications of metabolic and bariatric surgery should be suggested to receive surgical treatment early in order to achieve better clinical outcomes.

Preparation and the effect of antitumor of DNA plasmid lipidosome vaccine based VEGFR2 extracellular region by immunization activated in vitro / 中国临床药理学与治疗学

AIM: The DNA plasmid lipidosome (LP) vaccine based VEGFR2 extracellular region (exVEGFR2) was prepared in order to provide a new approach for cancer active immunotherapy. METHODS: High fidelity PCR was used to amplify the target sequence of exVEGFR2 with two restriction site of Kpn and Xba. The plasmid of pCMV/exVEGFR2 was constructed by connected exVEGFR2 with pCMV empty plasmid. The activity of immune activation was detected by ELISA. CTLs mediated cytotoxic activity was analyzed by

Acute myeloid leukemia with BCR-ABL p210 fusion gene-positive: report of one case and review of literature / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics of acute myeloid leukemia with BCR-ABL p210 fusion gene-positive.Methods:The clinical characteristics of a patient diagnosed in the Second Hospital of Jiaxing were analyzed and the related literature was reviewed.Results:BCR-ABL p210 fusion gene and Philadelphia chromosome (Ph) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH). Imatinib associated with multi-drug intravenous chemotherapy resulted in poor efficacy.Conclusions:Patient with Ph +/BCR-ABL + acute myeloid leukemia is rare with a very poor prognosis. There is no unified standard treatment and the efficacy of tyrosine kinase inhibitors is unclear. Intravenous chemotherapy combined with hematopoietic stem cell transplantation is expected to change the prognosis.

Novel Coronavirus Infection Response ：Prevention and Control Strategies Based on Drug ，Material Supply and Emergency Management / 中国药房

OBJECTIVE：To provide drug ，material supp ly and emergency management reference for novel coronavirus （SARS-CoV-2）infection in pharmacy staff in hospital. METHODS ：The method of 5M1E was used to analyze the six main factors，including man ，machine，material，method，environment and measurement of drug ，material supply and emergency management. The relevant prevention and control strategies were put forward. RESULTS & CONCLUSIONS ：In the drug ，material supply and emergency management of epidemic prevention and control ，the man factors were involved ，such as mainly pharmacists from pharmacy departments of medical institutions. At the same time ，the management also involved machine factors such as drug storage，cleaning and disinfection ；material factors such as emergency drugs ，disinfection products ，in vitro diagnostic reagents ， the guarantee of medicine materials for medical team ，investigational products ；methods factors such as relevant management measures；environmental factors such as storage environment and facilities ；measurement factors such as drug use ，drug and substance reserve. In view of the above factors ，it is suggested to strengthen the professional knowledge and communication skills training of pharmacists ，and strengthen humanistic care ，so as to improve their post competency ，communication in emergency response and psychological tolerance. Equipment and materials management shall be strengthened ，and equipment maintenance and disinfection shall be done well to ensure normal use of equipment. According to the evidence-based method ，the emergency drug list should be established. According to the disinfection protection requirements ，the disinfection products should be reasonably selected and their quality and sufficient inventory should be ensured. The qualified in vitro diagnostic reagents should be purchased in time. The investigational products should be managed reasonably according to the relevant requirements of clinical trials ，to ensure the drug and material supply of medical team members. Emergency plans and standard operating procedures shall be formulated，the principle of sympathetic drug use shall be followed ，and the management of off-label drug use and early warning of drug and material shortage shall be done well. Reasonable storage space should be reserved to strengthen environmental monitoring and disinfection. We should strengthen the monitoring and reporting of daily data ，strengthen the quality monitoring ， and accept the independent audit of the third party. Above strategies are helpful to improve the ability of drug supply risk identification and response ability ，and cooperate with the medical team to timely rescue patients.

Analysis of AVPR2 variant in a neonate with congenital nephrogenic diabetes insipidus / 中华医学遗传学杂志

OBJECTIVE@#To detect potential variant in a male neonate affected with congenital nephrogenic diabetes insipidus (CNDI).@*METHODS@#Clinical data of the patient was collected. Genomic DNA was extracted from peripheral blood samples from the child and his parents. The whole coding regions of the arginine vasopressin V2 receptor (AVPR2) gene were amplified by PCR and subjected to Sanger sequencing.@*RESULTS@#The patient presented recurrent fever and polyuria after birth. Multiple blood gas analyses indicated hypernatremia. Ultrasound showed bilateral hydronephrosis and hydroureter. The patient was partially responsive to hydrochlorothiazide. DNA analysis identified a hemizygous frameshift variant c.890-899delACCCGGAGGC in exon 2 of the AVPR2 gene in the proband. His mother was heterozygous for the same variant.@*CONCLUSION@#The c.890-899delACCCGGAGGC variant of the AVPR2 gene probably underlies the CNDI in the child. Above discovery has enriched to spectrum of CNDI associated variants.

Analysis of epidemic characteristics of hand-foot-mouth disease Virus using circular distribution method / 公共卫生与预防医学

Objective To understand the epidemic characteristics of different virus types of hand, foot and mouth disease (HFMD) in Zhaotong City, and provide guidance and recommendations for the prevention and control of HFMD, and to analyze seasonal characteristics of different virus types of HFMD in Zhaotong City. Methods The epidemiological characteristics of different virus types of HFMD in Zhaotong City from 2014 to 2017 were analyzed using the concentration and circular distribution methods. Results The main pathogens detected were EV71, Cox A16 and other enteroviruses, which were 216, 182, and 294, respectively, accounting for 57.45%, 73.44%, and 67.11%. M was 0.86, indicating that EV71 had strong seasonality. The Rayleigh test showed statistically significant differences (Z = 99.53, P <0.001). ā = 157 °, the peak day of onset was May 10, similar to untyped (May 16), the peak period was April 21-June 1, and the epidemic period was April 1-June 21. Conclusion According to the incubation period of hand-foot-mouth disease and the period of time during which the vaccine develops protective effects, vaccination of hand-foot-mouth disease vaccine at the peak period has a good guiding significance for the timeliness and pertinence of vaccination.

Congenital granular cell epulis: a case report / 中华围产医学杂志

This article reports the clinical manifestations, auxiliary examination, diagnosis, treatment, and prognosis of a congenital granular cell epulis (CGCE) case. A baby girl was admitted to Children's Hospital of Zhejiang University School of Medicine seven hours after birth due to difficulty in oral feeding caused by an oral cavity tumor detected prenatally. A palatine surgical resection was performed under general anesthesia based on imaging and related examination findings after admission. The patient was diagnosed as CGCE according to the pathological findings and discharged. During the follow-up, a new tooth emerged from the tumor resection site two weeks after discharge. The affected tooth was extracted at the Department of Stomatology of the hospital four weeks after discharge. The patient has no recurrence at follow-up visits till four months after the operation.