Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine (version 2024) / 中华创伤杂志

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Comparative analysis of work-related injury appraisal of 13 cases of occupational brucellosis / 环境与职业医学

Background According to the Classification and Catalogue of Occupational Diseases, brucellosis is one of the notifiable occupational infectious diseases, which occurs from time to time in the occupational population. Objective To compare the work-related injury appraisal process and results of 13 cases of brucellosis at both provincial and municipal levels, analyze and summarize the bias in the practical work of labor capacity identification for occupational diseases such as brucellosis by appraisal management departments and experts, and propose suggestions for optimizing appraisal work. Methods A comparative study was conducted on the objective examination results and labor capacity appraisal conclusions based on the occupational contact history, clinical diagnosis, occupational disease diagnosis staging, and labor capacity appraisal of 13 patients with brucellosis. The reasons for the inconsistency between the initial appraisal conclusion by institutions at the municipal level and the final appraisal conclusion by institutions at the provincial level were compared and analyzed. Results All of the 13 patients with brucellosis applied for municipal-level labor capacity identification after being identified as work-related injuries, 11 of which did not receive a disability level, and 2 were rated as level 10 disability. Four of those who did not receive the disability rate applied for provincial-level labor capacity identification. As a result, 2 cases were maintained original appraisal conclusions, while the other 2 changed the conclusions to level 9 disability and level 10 disability respectively. It was the first time in Shijiangzhuang municipal-level primary labor capacity appraisal and Hebei provincial-level labor capacity re-appraisal that the work-related injury caused by occupational brucellosis was rated as level 9 disability or level 10 disability. Hence, the lessons learned from this comparative analysis are that the degree of target organ damage and (or) organ dysfunction are the direct basis for work-related injury appraisal; an objective and scientific labor capacity identification for occupational brucellosis should base on the each case of disability evaluation, identify the relevant target organ damage and the degree of dysfunction, and rate the disability level after a comprehensive appraisal. Conclusion This analysis would be a guidance to the identification of labor capacity for occupational brucellosis in Hebei Province and the whole country. There is a hysteresis issue in the occupational disease provisions in the national standard GB/T 16180—2014 Standard for identify work ability—Gradation of disability caused by work-related injuries and occupatiaonal diseases. In current situation, appraisal experts should not only search for clauses that directly correspond to the occupational diseases and injuries, but also target conditions not covered in the clauses and conduct assessment based on the characteristics of occupational diseases, with scientific, accurate, and flexible application of the clauses in the standard and appendix, so as to make fair, just, and professional appraisal conclusions.

Prospective Clinical Study of Combined Treatment of Periodontal Orthodontics for Chronic Periodontitis / 昆明医科大学学报

Objective To investigate the effect of dynamic monitoring of occlusal force on the final therapeutic effect and the change of periodontal supporting tissue during combined periodontal orthodontic treatment.Methods The periodontal clinical index of 20 patients with traditional periodontal orthodontic treatment and 20 patients with combined periodontal orthodontic treatment assisted by T-Scan Ⅲ and Anycheck digital occlusion analysis system were compared before,during and after treatment,as well as the changes of bite force,bite time and tooth mobility in the experimental group.Results The depth of periodontal pocket(PD),loss of attachment(AL),bleeding index(BI)and tooth looseness were significantly reduced after combined periodontal orthodontic treatment in both groups.In the control group,the percentage of anterior and posterior biting force changed obviously,and the occlusion force balance was improved.Conclusion The combined treatment of periodontitis and orthodontics can improve the periodontal tissue of patients with periodontitis,and T-Scan system can observe and guide the adjustment of occlusal and better achieve occlusion force balance.

Design of a storage device for lymph node specimens of gynecological malignant tumors and its application / 中华护理杂志

Objective To design a storage device for lymph node specimens of gynecological malignant tumors and to evaluate its application effect.Methods The specimen depository is composed of 3 parts,including storage frame,partition plate and marking plate.391 patients with gynecological malignant tumor surgeries requiring collection of retroperitoneal lymph nodes were selected in the operating room of a tertiary A hospital in Zhejiang Province from January to December 2022 in accordance with the operation schedule.They were randomly divided into an experimental group(n=196)and a control group(n=195).Patients in the experimental group used a newly developed storage device,while the control group was with traditional device.The incidence of additional verification specimens by doctors,the average time for disposing of lymph node specimens,and the job satisfaction survey of doctors and nurses were compared.Results Within a period of 12 months after utilizing this easily recognizable specimen storage device,the additional verification rate in the experimental group was 10.62％compared with the rate of 72.48％in the control group.The average time of disposing lymph node specimens was reduced from(8.3±0.9)to(5.2±0.3)minutes.Doctors and nurses in the experimental group reported a higher level of satisfaction for the specimen storage device(P＜0.05).Conclusion Utilizing the newly designed specimen storage device can help medical staff to alleviate their workload,enhance their work efficiency,raise their job satisfaction,and ensure the accuracy of pathological results.

Epimedin B exhibits pigmentation by increasing tyrosinase family proteins expression,activity,and stability / 药物分析学报

Epimedin B(EB)is one of the main flavonoid ingredients present in Epimedium brevicornum Maxim.,a traditional herb widely used in China.Our previous study showed that EB was a stronger inducer of melanogenesis and an activator of tyrosinase(TYR).However,the role of EB in melanogenesis and the mechanism underlying the regulation remain unclear.Herein,as an extension to our previous investi-gation,we provide comprehensive evidence of EB-induced pigmentation in vivo and in vitro and eluci-date the melanogenesis mechanism by assessing its effects on the TYR family of proteins(TYRs)in terms of expression,activity,and stability.The results showed that EB increased TYRs expression through microphthalmia-associated transcription factor-mediated p-Akt(referred to as protein kinase B(PKB))/glycogen synthase kinase 3β(GSK3β)/β-catenin,p-p70 S6 kinase cascades,and protein 38(p38)/mitogen-activated protein(MAP)kinase(MAPK)and extracellular regulated protein kinases(ERK)/MAPK pathways,after which EB increased the number of melanosomes and promoted their maturation for melanogenesis in melanoma cells and human primary melanocytes/skin tissues.Furthermore,EB exerted repigmentation by stimulating TYR activity in hydroquinone-and N-phenylthiourea-induced TYR inhibitive models,including melanoma cells,zebrafish,and mice.Finally,EB ameliorated monobenzone-induced depigmentation in vitro and in vivo through the enhancement of TYRs stability by inhibiting TYR misfolding,TYR-related protein 1 formation,and retention in the endoplasmic reticulum and then by downregulating the ubiquitination and proteolysis processes.These data conclude that EB can target TYRs and alter their expression,activity,and stability,thus stimulating their pigmentation function,which might provide a novel rational strategy for hypopigmentation treatment in the pharmaceutical and cosmetic industries.

Effects of andrographolide on angiogenesis in diabetic foot rats and its mechanism / 中国药房

OBJECTIVE To investigate the effects of andrographolide （Andro） on angiogenesis in rats with diabetic foot and to explore its mechanism of action based on the Hippo-Yes-associated protein （YAP） signaling pathway. METHODS The rat model of type 2 diabetes was established by using low-dose streptozotocin combined with high-fat and high-glucose diet. On the basis of successful modeling， the rat model of diabetes foot was established by scalding. Model rats were randomly divided into 5 groups with 12 rats in each group： model group， Andro low-dose， medium-dose， and high-dose groups （1， 10， and 20 mg/kg）， as well as inhibitor group （20 mg/kg Andro+100 mg/kg of verteporfin， an specific inhibitor of Hippo-YAP signaling pathway）； other 12 healthy rats were included in the Control group. Rats in each group were intragastrically and intraperitoneally injected with solvents or corresponding drugs， once a day， for 2 consecutive weeks. The wound healing， fasting blood glucose （FBG） and fasting insulin （FINS） were detected in rats after medication. HE staining was performed to observe the tissue damage and capillary number of rat trauma； the number of endothelial progenitor cells （EPCs） in peripheral blood of rats was counted by using flow cytometry； the contents of serum total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C） in rats were determined by fully automatic biochemical analyzer； the expressions of hypoxia- inducible factor 1α （HIF-1α）， vascular endothelial growth factor （VEGF） and Hippo-YAP signaling pathway-related proteins in the traumatic tissues of rats in each group were detected by Western blot. RESULTS Compared with Control group， the wound healing rate， capillary number， the proportion of EPCs， HDL-C content， as well as the protein expression levels of HIF-1α and VEGF and the phosphorylation levels of mammalian Ste20-like kinase 1， large tumor suppressor gene 1 and YAP proteins were significantly reduced in the model group， while the FBG， FINS levels and TC， TG and LDL-C contents were significantly increased （P＜0.05）. Compared with model group， the above indexes were significantly reversed in Andro low-dose， medium-dose and high-dose group， in a dose-dependent manner （P＜ 0.05）； verteporfin attenuated the above reversal effect of Andro （P＜0.05）. CONCLUSIONS Andro has the effects of lowering blood glucose and blood lipids， promoting blood vessel formation and wound healing in rats with diabetic foot， and its mechanism of action may be related to the activation of Hippo-YAP signaling pathway.

Difference in Intestinal Flora Among Patients with Esophageal Squamous Cell Carcinoma and Normal Population / 肿瘤防治研究

Objective To investigate the difference in intestinal flora among patients with esophageal squamous cell carcinoma and normal population and to provide a basis for the early diagnosis of esophageal squamous cell carcinoma as a marker. Methods DNA was extracted from biopsy tissue samples of 30 patients with esophageal squamous cell carcinoma (observation group) and 25 healthy people (control group) by microbial amplification sequencing. The integrity and quality of DNA were detected. The composition and abundance of intestinal flora in the samples of the two groups were determined. Results A great similarity in beta diversity was found between the two groups, but some differences were also observed. The relative abundance of Proteobacteria and Verrucomicrobia in the observation group was higher than that in the control group (P<0.05). The relative abundance of Megamonas in the observation group was lower than that in the control group (P=0.025). Conclusion Strengthening the study on the changes in intestinal flora among patients with esophageal squamous cell carcinoma may be of great significance for its prevention and treatment.

Study on the impact of regular supervision and communication on the nursing practice environment based on employee needs / 中华医院管理杂志

Objective:To analyze the impact of implementing regular supervision and communication based on employee needs in the management of head nurses on improving the nursing practice environment, for reference for improving the nursing proctice environment.Methods:In December 2020 and January 2022, convenience sampling method was used to select 5 nursing unit nurses from a hospital which implemented regular supervision and communication based on employee needs(January to December 2021) as the research subjects. The survey was conducted using the Gallup Q12 questionnaire(Q12 questionnaire), which included 12 items from 4 dimensions: basic needs, head nurse support, team cooperation, and self growth. At the same time, a focus group interview method was made to interviews 10 survey subjects regarding their regular supervision and communication experiences.Results:A total of 165 survey subjects were included in this study, including 77 before and 88 after the implementation.The average total score of the Q12 questionnaire increased from 53.75 points before implementation of supervision communication to 56.96 points after implementation, with a statistically significant difference( P<0.05). The scores of the four dimensions of basic needs, head nurse support, team collaboration, and self growth increased from 4.59 points, 4.41 points, 4.50 points, and 4.45 points before implementation to 4.84 points, 4.69 points, 4.75 points, and 4.75 points after implementation, with statistical significances( P<0.05). The interview results showed that supervisory communication can create a humanistic care atmosphere, enhance team cohesion, enhance self-efficacy, improve work efficiency, solve problems in a timely manner, and improve nursing quality. Conclusions:Implementing regular supervision and communication based on employee needs can strengthen the connection between the head nurse and nurses, and enhance nurses′ recognition of basic needs, head nurse support, teamwork, and self growth. It was conducive to creating a good nursing practice environment, meeting the emotional and growth needs of nurses, and improving their job satisfaction.

Establishment and evaluation of a rat model of coronary microvascular disease with qi deficiency and blood stasis syndrome / 中国实验动物学报

Objective The incidence of coronary microvascular disease(CMVD)is increasing annually.According to traditional Chinese medicine(TCM),CMVD belongs to the category of"collaterals",and qi deficiency and blood stasis are the main syndrome type of CMVD.Notably however,no studies have reported on the use of animal models of CMVD with qi deficiency and blood stasis.The current study therefore aimed to establish and evaluate a rat model of CMVD with qi deficiency and blood stasis syndrome.Methods Forty-five male SD rats were divided randomly into sham group,CMVD group,and CMVD + QXXY group(n = 15 rats per group).Rats in the CMVD + QXXY group were randomly deprived of sleep for 14～16 h/day for 6 weeks,and the model of qi deficiency syndrome was established.Animals in the sham group and the CMVD group were fed normally for 6 weeks.After 6 weeks,rats in the CMVD and CMVD + QXXY groups were anesthetized,their chests were opened,and embolic microspheres(40～120 μm)were injected into the left ventricle.Rats in the sham group underwent thoracotomy without injection of embolic microspheres.On day 7 after operation,relevant detection indicators were measured in each group.Results Compared with the sham group,the CMVD group showed a significant decrease in left ventricular ejection fraction and left ventricular shortening rate,while the activities of creatine kinase MB isoenzyme(CK-MB)and lactate dehydrogenase(LDH)were significantly increased.Heart function,hemorheology,myocardial enzyme index,and the degree of myocardial cell damage differed significantly between the CMVD + QXXY group compared with the sham group.Conclusions A rat model of CMVD + qi deficiency + blood stasis syndrome can be successfully established by sleep deprivation combined with intraventricular injection of embolic microspheres.This model will be suitable for the study of the pathogenesis of CMVD and the mechanisms of TCM.

Detection of Cucumber green mottle mosaic virus in low-concentration virus-infected seeds by improved one-step pre-amplification RT-qPCR.

BACKGROUND: Seeds were an important medium for long-distance transmission of plant viruses. Therefore, appropriate, more sensitive methods for detecting low concentrations of virus-infected in seeds were crucial to ensure the quality of seed lots. In this study, we have developed a one-step pre-amplification reverse transcription quantitative PCR (RT-qPCR) assay based on the TaqMan technology to detect Cucumber green mottle mosaic virus (CGMMV) in zucchini seeds. RESULT: Seed powder samples with simulated CGMMV-infected at a low concentration were prepared (the mass ratio 1:900 and 1:1000), and their uniformity were verified using one-step pre-amplification RT-qPCR. We used one-step pre-amplification RT-qPCR to detect CGMMV in low-concentration virus-infected seeds and compared this method with universal RT-qPCR and double antibody sandwich-enzyme-linked immunosorbent (DAS-ELISA) assay, the main methods used for virus detection in seeds. The minimum limit of detection (LOD) of the improved one-step pre-amplification RT-qPCR assays for simulated CGMMV-infected seeds in large lots seeds samples were 0.1%. CONCLUSIONS: One-step pre-amplification RT-qPCR assays could reliably and stably detected a single CGMMV-infected seed in 1000 seeds and demonstrated a higher detection sensitivity than universal RT-qPCR (infected seeds versus healthy seeds 1:900) and DAS-ELISA assay (infected seeds versus healthy seeds 1:500). Our improved one-step pre-amplification RT-qPCR assay have proved to be very suitable for the analysis of large seed lots.

Present practice of patients and their family as advisors overseas and its enlightenments to China / 中华医院管理杂志

Invitation of patients and their families as advisors in medical activities is conducive to enhancing patient safety and medical quality, as an innovative way for hospital reform and development. By analysis of such practice of overseas hospitals, the authors recommended on introducing this practice into China. The specific recommendations included creating a social support atmosphere for patient and family as advisors, promoting patient and family engagement by hospitals, establishing a management evaluation system for the patient and family engagement, improving the comprehensive literacy level of patient and family advisors, and building an internet platform for patient and family engagement.

Factors associated with consecutive and non-consecutive crashes on freeways: A two-level logistic modeling approach.

A consecutive crash consists of a primary crash and one or more secondary crashes that occur subsequently in a short period of time within a certain distance. It often affects a relatively large area of road space and the traffic disruption created can be difficult for traffic managers to control and resolve. This study identifies the factors delineating a primary crash that results in secondary crashes within a minute from a regular crash that does not result in any secondary crashes. Random-effects, random-parameter and two-level binary logistic regression models are applied to data collected on 8779 crashes on the freeway network of the Guizhou Province, China in 2018, of which 299 are consecutive crashes. According to the AIC values, the two-level logistic model outperforms the other two models. Rear-end primary crashes have a significant random effect varying across road segments on the occurrence of consecutive crashes. Various crash types (rear-end, roll-over and side-swipe), tunnel crash and foggy weather are positively associated with the possibility to cause subsequent consecutive crashes, whereas single-vehicle crash, truck involvement and the time periods with poorer natural lighting are less likely to incur consecutive crashes. Recommendations are provided to minimize the possibility of the occurrence of consecutive crashes on a freeway.

Research progress in role and mechanism of damage-associated molecular patterns in lung injury after acute spinal cord injury / 中华创伤杂志

Acute spinal cord injury（ASCI），commonly seen in spinal surgery，is usually caused by mechanical injury to the spine. ASCI can lead to secondary lung injury and even acute respiratory distress syndrome（ARDS），seriously endangering the life safety of patients. Damage-associated molecular pattern（DAMP）is a sort of endogenous substances released after injury，including intracellular proteins，extracellular matrix，secretory factors and nucleic acid-related products. DAMP released after ASCI activates downstream signaling pathways and participates in lung injuries. DAMP-related studies have revealed molecular mechanism of lung injury after ASCI，and explored the possible therapeutic targets of lung injury. In this study，the authors review the mechanism of action of DAMP in lung injury after ASCI and the role of different kinds of DAMP in lung injury，so as to provide new ideas for clinical treatment of lung injury after ASCI.

Status of hepatitis B virus infection among pregnant women in Taizhou City and the influence of hepatitis B vaccine immunization management on the status / 中华传染病杂志

Objective:To analyze the status of hepatitis B virus (HBV) infection in pregnant women in Taizhou City in recent years and the effect of immunization management of hepatitis B vaccine project on the status.Methods:The pregnant women hospitalized in Taizhou People′s Hospital, Taizhou Second People′s Hospital, Taizhou Traditional Chinese Medicine Hospital and Taixing People′s Hospital from 2014 to 2017 were enrolled. According to the HBV serological results, the pregnant women were divided into non-immune population, successful immunization population, previous HBV infection population, HBV infection population and atypical manifestation population. The year of immunization management for the implementation of the hepatitis B vaccine plan was 1992. The HBV infection status of the pregnant women was analyzed based on the year of delivery and vaccination status, respectively. Chi-square test and trend chi-square test were used for statistical analysis.Results:A total of 31 449 cases were included in this study, of which 13 203 (41.98%) were non-immunized, 10 123 (32.19%) were successfully immunized, 6 409 (20.38%) were previous HBV infected, 1 566(4.98%) were HBV infected, and 148(0.47%) cases were atypical manifestation. The negative rate of all HBV serological markers of pregnant women born before 1992 and after 1992 (including 1992) were 42.07%(10 794/25 657) and 41.59%(2 409/5 792), respectively, with no statistically significant difference ( χ2=0.44, P=0.51). The hepatitis B surface antibody (anti-HBs) positive rate of pregnant women born before 1992 was 28.95%(7 428/25 657), which was lower than 46.53%(2 695/5 792) of pregnant women born after 1992 (including 1992). The difference was statistically significant ( χ2=668.94, P<0.01), and showed an upward trend year by year ( χ2=602.11, P<0.01). The hepatitis B core antibody (anti-HBc) positive rate of pregnant women born after 1992 (including 1992) was 8.81%(510/5 792), which was lower than 22.99%(5 899/25 657) of pregnant women born before 1992, the difference was statistically significant ( χ2=589.10, P<0.01), and the overall trend was declining year by year ( χ2=478.72, P<0.01). The hepatitis B surface antigen (HBsAg) positive rate of pregnant women born before 1992 was 5.46%(1 402/25 657), which was higher than 2.83%(164/5 792) of pregnant women born after 1992 (including 1992), the difference was statistically significant ( χ2 =69.23, P <0.01), and the overall trend was decreasing ( χ2=49.25, P<0.01). Among pregnant women infected with HBV, the negative rate of hepatitis B e antigen (HBeAg) was 78.16%(1 224/1 566). Conclusions:Pregnant women with HBV infection in Taizhou City are mainly HBeAg negative. Hepatitis B vaccine immunization management significantly reduces the HBsAg positive rate and anti-HBc positive rate of pregnant women, and increases the positive rate of anti-HBs, while the rate of all HBV serum marker negative is not significantly decreased. Horizontal transmission may still be a risk factor for HBV present and previous infections.

Expert consensus on rehabilitation strategies for traumatic spinal cord injury / 中华创伤杂志

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Clinical analysis of alcoholic and non-alcoholic Wernicke′s encephalopathy / 中华全科医师杂志

Objective:To review the etiology, clinical manifestations, cranial MRI features and outcome of alcoholic and non-alcoholic Wernicke′s encephalopathy (WE).Methods:The clinical data of 51 WE patients admitted in Peking Union Medical College Hospital from May 1999 to May 2019 were retrospectively analyzed, including 10 cases of alcoholic WE (19.6%) and 41 cases of non-alcoholic WE (80.4%). The clinical manifestations, MRI results, treatment and efficacy of the two groups were compared.Results:The gastrointestinal surgery (17.1%, 7/41) , biliary and pancreatic diseases (14.6%, 6/41) , malignancy (12.2%, 5/41) were the common causes of non-alcoholic WE. Only 39.2% (20/51) of WE patients had typical triad syndrome of mental disorders, ocular symptoms and ataxia. There was no significant difference in the proportion of patients with typical triad syndrome between alcoholic WE and non-alcoholic WE groups [5/10 vs. 36.6% (15/41) , χ 2=0.959, P=0.619]. Mental disorders were more common in non-alcoholic WE [95.1% (39/41) vs. 70.0% χ 2=5.738, P=0.017]. In 45 WE patients undergoing cranial MRI, 53.3% (24/45) had typical symmetry abnormal signals in bilateral thalamus, periaqueductal region and paraventricular region of the third ventricle, in which non-alcoholic WE was more likely to have atypical lesions in comparison with alcoholic WE [66.7% (14/21) vs. 1/3, χ 2=10.578, P=0.001]. Forty-nine patients were treated with vitamin B 1 during hospitalization and symptoms were improved in 91.8% (45/49). The response to vitamin B 1 in non-alcoholic WE was better than that in alcoholic WE [97.4% (38/39) vs. 7/10, χ 2=8.128, P=0.017]. Conclusions:Non-alcoholic Wernicke′s encephalopathy deserves clinical attention. Compared with alcoholic WE, non-alcoholic WE may present mental disorders more frequently, and is more likely to have atypical lesions in cranial MRI, and has better response to vitamin B 1 treatment. Early identification, diagnosis and supplementation of vitamin B 1 can improve the prognosis of WE.

Laboratory confirmation of an outbreak of respiratory infectious disease caused by human adenovirus 3 in Beijing / 中华微生物学和免疫学杂志

Objective:To confirm the possible pathogen causing an outbreak of respiratory infectious disease in Beijing.Methods:Oropharyngeal swabs were collected from 14 cases with fever and detected by RT-PCR for respiratory viruses and bacteria. For specimens positive for adenoviruses, Fiber, Hexon and Penton gene fragments were amplified with specific primers and sequenced. BLAST and phylogenetic tree were used for sequence analysis.Results:All of the 14 specimens were adenovirus-positive. BLAST analysis of the sequences of Fiber, hexon and Penton genes showed that the 14 cases were all caused by adenovirus 3. The phylogenic tree analysis indicated that this adenovirus was closely related to an adenovirus of 3a51 genotype (GenBank No: KF268123) isolated in the USA in 2007.Conclusions:Human adenovirus genotype 3a51 caused this outbreak of respiratory infectious disease in Beijing.

Mortality and potential life lost of drowning in Zhoushan residents / 预防医学

Objective@#To learn the characteristics of drowning deaths and potential years of life lost（PYLL）among residents in Zhoushan，and to provide basis for formulating drowning prevention and control measures. @*Methods@#The death surveillance data in Zhoushan from 2009 to 2018 were collected from Zhejiang Chronic Disease Surveillance Information Management System. Demographic features，causes of drowning，life and labor lost due to drowning were analyzed through indicators such as mortality，standardized mortality，early death index，PYLL and working potential years of life lost（WPYLL）. @*Results@#The crude and standardized drowning mortality of Zhoushan residents were 7.97/100 000 and 4.68/100 000. The drowning mortality showed a decreasing trend from 2009 to 2018（P<0.05）. The mortality of drowning in males was 8.03/100 000，which was higher than 1.33/100 000 in females（P<0.05）. Totally 322 deaths from drowning were fishery workers，accounting for 41.44%. The main cause of drowning death in residents aged 0-14 years，15-29 years and 65 years or above was accidental fall，accounting for 36.11%（13 cases），23.91%（11 cases）and 14.40%（47 cases），respectively. The main cause of drowning death in residents aged 30-44 years and 45-64 years was ship accident，accounting for 33.33%（58 cases）and 36.01%（130 cases），respectively. PYLL and WPYLL caused by drowning death were 22 511 and 11 911 person-years，of which residents aged 30 to 64 years were accounted for 73.33% and 70.55%. The early death index was 28.97. @*Conclusion@#Drowning mortality in Zhoushan showed an downward trend from 2009 to 2018. Men and fishery workers are at higher risk of death from drowning. Drowning can lead to serious life loss，especially for population aged 30-64 years.

Validation Study of the Chinese Version of Addenbrooke's Cognitive Examination III for Diagnosing Mild Cognitive Impairment and Mild Dementia

BACKGROUND AND PURPOSE: There are only a few cognitive screening tests for the Chinese-speaking population, and so this study aimed to validate the Chinese version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with the Chinese versions of the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). METHODS: The 176 included individuals were divided into 3 groups: mild dementia group, MCI group, and normal control group. MMSE, MoCA, and ACE-III were administered to all participants by researchers who were blinded to the clinical grouping. The receiver operating characteristic (ROC) curves were analyzed. RESULTS: ACE-III exhibited good internal consistency and convergent validity. Age and education level significantly influenced the total ACE-III scores. When screening MCI, the area under the ROC curve (AUC) was significantly larger for ACE-III than for MMSE (0.88 vs. 0.72, p<0.05) and MoCA (0.88 vs. 0.76, p<0.05). ACE-III showed higher sensitivity (0.75) and specificity (0.89) than MMSE (0.64 and 0.63, respectively) and MoCA (0.67 and 0.77) at the optimal cutoff score of 88/89. For detecting mild dementia, ACE-III yielded satisfactory sensitivity (0.94) and specificity (0.83) at the optimal cutoff score of 74/75. The AUC of ACE-III was 0.95, which was comparable to those of MMSE (0.95) and MoCA (0.91). In participants with ≥12 years of education, the AUC was significantly larger for ACE-III than for MMSE when detecting MCI (0.90 vs. 0.68, p<0.05) and mild dementia (0.97 vs. 0.90, p<0.05). CONCLUSIONS: The present study has verified that ACE-III is a reliable and accurate tool for screening MCI and mild dementia in the Chinese-speaking population, and is significantly superior to MMSE and MoCA for detecting MCI.

Effect of ginkgo biloba L. extract on apoptosis and NF-κB signaling pathways in the spleen tissue of mice with radiation damage / 国际中医中药杂志

Objective To investigate the influence of Ginkgo biloba L. extract (EGB) on the expression of apoptosis-related protein and NF-κB signaling pathway in the spleen tissue of mice with radiation damage. Methods The mice were divided randomly into normal control group (NC), irradiation control group (IC), low dose EGB group (IC+EGBL), medium dose EGB group (IC+EGBM) and high dose EGB group (IC+EGBH) according to the random number table, with 12 rats in each group. The mice in the low, middle and high dose EGB groups were given EGB respectively by 5, 10, 20 mg/kg, and the normal and irradiation control group were given saline by intraperitoneal injection once daily for 14 days. On the 15th day, the mice in all groups were uniformly irradiated with 4.0 Gy γ-rays for one time except normal control group. After 24 hours, Bcl-2, Bax and caspase-3 protein expression were measured by immunohistochemical method. The IKKβ expression was detected by qRT-PCR method, and the content of NF-κB p65 and IKKα in serum was detected by Elisa method in spleen tissue. Results Comparing with IC group, the expression of Bax (54.31 ± 1.59, 42.04 ± 1.56, 32.08 ± 2.43 vs. 68.68 ± 3.12) and caspase-3 protein (55.73 ± 2.61, 45.81 ± 2.59, 36.78 ± 2.23 vs. 72.18 ± 1.84) in IC+EGBL, IC+EGBM and IC+EGBH group were significantly decreased (P<0.05), the expression of Bcl-2 protein (30.33 ± 1.28, 39.80 ± 2.86, 44.42 ± 3.64 vs. 22.80 ± 2.01) in IC+EGBL, IC+EGBM and IC+EGBH group significantly increased (P<0.05), the expression of IKKβ mRNA (1.43 ± 0.06, 1.31 ± 0.06, 1.17 ± 0.09 vs. 1.64 ± 0.10) and the level of NF-κB p65 (129.38 ± 8.41 pg/ml, 111.28 ± 9.09 pg/ml, 95.41 ± 6.88 pg/ml vs. 145.64 ± 6.29 pg/ml) and IKKα (160.10 ± 8.94 pg/ml, 144.00 ± 8.36 pg/ml, 108.84 ± 13.74 pg/ml vs. 176.38 ± 8.54 pg/ml) in IC+EGBL, IC+EGBM and IC+EGBH group significantly decreased (P<0.05). Conclusions The EGB can reduce the expression of apoptotic protein Bax and caspase-3 in spleen cells induced by radiation, elevate the expression level of apoptotic protein Bcl-2, and inhibit the damage caused by radiation by regulating NF-κB signaling pathway.