Multi-Epitope Fusion Protein Eg mefAg-1 as a Serodiagnostic Candidate for Cystic Echinococcosis in Sheep.

Cystic echinococcosis (CE) in sheep is a hazardous zoonotic parasitic disease that is caused by Echinococcus granulosus (Eg). At present, serological test is an important diagnostic method for Eg infection in domestic animals. Here, a fusion protein Eg mefAg-1 harboring 8 dominant B-cell epitopes of Eg such as antigen B, tetraspanin 1, tetraspanin 6, reticulon and Eg95 was produced in E. coli and evaluated for CE in sheep by indirect ELISA. Eg mefAg-1 showed in ELISA a high sensitivity (93.41%) and specificity (99.31%), with a coincidence rate of 97.02%. Overall, it is suggested that the Eg mefAg-1 could be a potential antigen candidate for CE serodiagnosis in sheep.

Cost-effectiveness of a comprehensive programme for drug-resistant tuberculosis in China.

OBJECTIVE: To investigate the cost-effectiveness of a comprehensive programme for drug-resistant tuberculosis launched in four sites in China in 2011. METHODS: In 2011-2012, we reviewed the records of 172 patients with drug-resistant tuberculosis who enrolled in the comprehensive programme and we collected relevant administrative data from hospitals and China's public health agency. For comparison, we examined a cohort of 81 patients who were treated for drug-resistant tuberculosis in 2006-2009. We performed a cost-effectiveness analysis, from a societal perspective, that included probabilistic uncertainty. We measured early treatment outcomes based on three-month culture results and modelled longer-term outcomes to facilitate estimation of the comprehensive programme's cost per disability-adjusted life-year (DALY) averted. FINDINGS: The comprehensive programme cost 8837 United States dollars (US$) per patient treated. Low enrolment rates meant that some fixed costs were higher, per patient, than expected. Although the comprehensive programme appeared 30 times more costly than the previous one, it resulted in greater health benefits. The comprehensive programme, which cost US$ 639 (95% credible interval: 112 to 1322) per DALY averted, satisfied the World Health Organization's criterion for a very cost-effective intervention. CONCLUSION: The comprehensive programme, which included rapid screening, standardized care and financial protection, improved individual outcomes for MDR tuberculosis in a cost-effective manner. To support post-2015 global heath targets, the comprehensive programme should be expanded to non-residents and other areas of China.

Construction of a Single Chain Variable Fragment Antibody (scFv) against Carbaryl and Its Interaction with Carbaryl.

Carbaryl is a low molecular weight insecticide that inhibits cholinesterase. Residues of carbaryl in food and the environment have damaged human health. A high-specificity scFv that can identify carbaryl is still lacking. In the present study, an anti-carbaryl scFv gene was prepared by cloning VL and VH genes from hybridoma cells secreting monoclonal antibody, then VH and VL were fused together using splicing by overlap extension (SOE) PCR with a flexible polypeptide linker connector (Gly4Ser)3, and then the scFv-pET-26b recombinant plasmid was constructed and transformed into E. coli BL21 for expression using IPTG as an inducer. The expressed recombinant protein was identified by SDS-PAGE and ELISA. The three-dimensional structure of the anti-carbaryl scFv was constructed by computer modeling, and carbaryl was docked to the scFv model to obtain the structure of the binding complex. The binding site was composed of Ala51, Ser52, Ile51, Gly54, Ser56, Arg98, and Gly100. This helps to understand the mechanism of interaction between anti-carbaryl antibody and antigen. Furthermore, it provides guidance for in vitro affinity maturation of anti-carbaryl antibody.

A cross-sectional study of the psychological status of 33,706 hospital workers at the late stage of the COVID-19 outbreak.

BACKGROUND: Hospital workers have been under intense psychological pressure since the COVID-19 outbreak. We analyzed the psychological status of hospital staff in the late period of the COVID-19 to provide a basis for the construction of global health care after the COVID-19 outbreak. METHODS: We used online surveys to assess participants' self-reported symptoms at the late stage of the outbreak. This study collected data on sociodemographic characteristics, epidemic-related factors, psychological status (PHQ-9, GAD-7, and PHQ-15), psychological assistance needs, perceived stress and support, PTSD symptoms (PCL-C) and suicidal and self-injurious ideation (SSI). Participants were hospital workers in all positions from 46 hospitals. Chi-square tests to compare the scales and logistic regression analysis were used to identify risk factors for PTSD and SSI. RESULTS: Among the 33,706 participants, the prevalences of depression, anxiety, somatic symptoms, PTSD symptoms, and SSI were 35.8%, 24.4%, 49.7%, 5.0%, and 1.3%, respectively. Logistic regression analysis showed that work in a general ward, attention to the epidemic, high education, work in non-first-line departments, insufficient social support, and anxiety and somatization symptoms were influencing factors of PTSD (P<0.05). The independent risk factors for SSI were female gender; psychological assistance needs; contact with severe COVID-19 patients; high stress at work; single or divorced marital status; insufficient social support; and depression, anxiety or PTSD symptoms (P<0.05). LIMITATIONS: This cross-sectional study could not reveal causality, and voluntary participation may have led to selection bias. The longer longitudinal studies are needed to determine the long-term psychological impact. CONCLUSION: This COVID-19 pandemic had a sustained, strong psychological impact on hospital workers, and hospital workers with PTSD symptoms were a high-risk group for SSI in the later period of the epidemic. Continuous attention and positive psychological intervention are of great significance for specific populations.

Antimicrobial resistance profiling and molecular typing of ruminant-borne isolates of Clostridium perfringens from Xinjiang, China.

OBJECTIVES: Clostridium perfringens (C. perfringens) can cause intestinal diseases in livestock and humans, which seriously threatens the healthy development of animal husbandry and human food safety. Here, the characteristics of antimicrobial resistance and molecular typing of ruminant-borne strains of C. perfringens in Xinjiang, China were explored and profiled. METHODS: A total of 307 clinical feces collected from ruminants (cattle and sheep) with diarrheal symptoms were screened for C. perfringens. The recovered isolates were characterized in respect to their antimicrobial resistance pattern and molecular typing. RESULTS: A total of 109 isolates of C. perfringens were isolated from 307 clinical feces of ruminants, most of which displayed the multidrug resistance (MDR) phenotype. Demonstration of the quinolone-resistance gene was the highest among the isolates (70.6%). The multiplex PCR typing based on toxin genes showed that type A and type D strains made up 82.6% (90/109) and 17.4% (19/109), among which, the isolates carrying ß2 gene occupied 43.3% (39/90) of type A strains and 31.6% (6/19) of type D strains. These isolates were divided into 6 genotypes (I-VI) by enterobacterial repetitive intergenic consensus sequence-based PCR (ERIC-PCR) method. A total of 33 ST types (ST1-ST33) were identified by multilocus sequence typing (MLST) method. CONCLUSION: C. perfringens isolates with multidrug resistance (MDR) were frequent and circulating in ruminants. Among them, type A-Ⅰ-ST19 was the dominant genotype of C. perfringens, displaying obvious genetic diversity. This study provided important epidemiological data for the risk assessment of food safety associated with ruminant-borne C. perfringens in Xinjiang, China.

Molecular detection and genetic variability of Ehrlichia canis in pet dogs in Xinjiang, China.

BACKGROUND AND AIM: As a tick-borne zoonotic pathogen, Ehrlichia canis has already posed a threat to public health and safety. This study aimed to clarify the prevalence and molecular characteristics of E. canis in pet dogs in Xinjiang, China. MATERIALS AND METHODS: A total of 297 blood samples of pet dogs and 709 skin ticks (Rhipicephalus sanguineus sensu lato) were subjected to molecular detection using PCR for E. canis 16S rRNA gene, and then, positive samples were amplified, sequenced, and phylogenetically analyzed for E. canis gp36 gene. RESULTS: The PCR detection showed that the positive rate of PCR was 12.12% (36/297) in blood samples and 15.23% (108/709) in tick samples, respectively. Based on the phylogenetic analysis of E. canis gp36 protein, these E. canis strains in different geographical regions of the world can be divided into Genogroup I and Genogroup II. Among them, the Xinjiang epidemic strain XJ-6 and 533, 36, 1055, Kasur1, and Jake strains were clustered into subgroup 1.1 of Genogroup I, while the XJ-2, XJ-21, and XJ-35 strains and the TWN1, TWN4, CM180, and CM196 strains were closely related and belonged to subgroup 2.2 of Genogroup II, displaying high genetic diversity. CONCLUSION: This is the first study focusing on the molecular epidemiology of E. canis infection in pet dogs, which revealed that E. canis infection had been occurred in Xinjiang, China. More importantly, this study confirmed that the substantial variability in immunoreactive protein gp36 from E. canis strains circulating in pet dogs.

The psychological status of 8817 hospital workers during COVID-19 Epidemic: A cross-sectional study in Chongqing.

BACKGROUND: There was an outbreak of COVID-19 towards the end of 2019 in China, which spread all over the world rapidly. The Chinese healthcare system is facing a big challenge where hospital workers are experiencing enormous psychological pressure. This study aimed to (1) investigate the psychological status of hospital workers and (2) provide references for psychological crisis intervention in the future. METHOD: An online survey was conducted to collect sociodemographic features, epidemic-related factors, results of PHQ-9, GAD-7, PHQ-15, suicidal and self-harm ideation (SSI), and the score of stress and support scales. Chi-square test, t-test, non-parametric, and logistic regression analysis were used to detect the risk factors to psychological effect and SSI. RESULTS: 8817 hospital workers participated in this online survey. The prevalence of depression, anxiety, somatic symptoms, and SSI were 30.2%, 20.7%, 46.2%, and 6.5%, respectively. Logistic regression analysis showed that female, single, Tujia minority, educational background of junior or below, designated or county hospital, need for psychological assistance before or during the epidemic, unconfident about defeating COVID-19, ignorance about the epidemic, willingness of attending parties, and poor self-rated health condition were independent factors associated with high-level depression, somatic symptom, and SSI among hospital workers (P<0.05). LIMITATIONS: This cross-sectional study cannot reveal the causality, and voluntary participation could be prone to selection bias. A modified epidemic-related stress and support scale without standardization was used. The number of hospital workers in each hospital was unavailable. CONCLUSION: There were a high level of psychological impact and SSI among hospital workers, which needed to be addressed. County hospital workers were more severe and easier to be neglected. More studies on cognitive and behavioral subsequence after a public health disaster among hospital workers are needed.

Effect and mechanism of protein kinase N1 on the proliferation of mouse cardiomyocytes / 新乡医学院学报

Objective To explore the effect and mechanism of protein kinase N1(PKN1)on the proliferation of mouse cardiomyocytes.Methods Two 1-day-old mice were anesthetized with isoflurane,and their cardiomyocytes were isolated and divided into the control group and the interference group.The cardiomyocytes in the interference group were transfected with PKN1 fragments,while the cardiomyocytes in the control group were transfected with control fragments.According to the random number table method,10 mice were divided into the normal group and the observation group,with 5 mice in each group.The mice in the observation group were injected with PKN1 adenovirus in situ in the heart,while the mice in the normal group were injected with empty adenovirus in situ in the heart.The Ki-67 positive expression in myocardial cells and tissues of mice in the four groups was detected by immunofluorescence assay,indicating the proliferation ability of cardiomyocytes.The PKN1 mRNA expression in cardiomyocytes of mice in the control group and interference group was measured by real-time fluorescence quan-titative polymerase chain reaction.The expression of PKN1 and cyclin D1 proteins in cardiomyocytes of mice in the control group and interference group was determined by Western blot.Results The positive expression rates of Ki-67 in myocardial cells of mice in the interference group was significantly lower than that in the control group(t=11.201,P＜0.01);the positive expression rate of Ki-67 in myocardial tissue of mice in the observation group was significantly lower than that in the normal group(t=11.851,P＜0.01).The relative expression level of PKN1 mRNA in cardiomyocytes of mice in the interference group was significantly lower than that in the control group(t=7.022,P＜0.01).The relative expression levels of PKN1 and cyclin D1 proteins in cardiomyocytes of mice in the interference group were significantly lower than those in the control group(t=5.762,6.884;P＜0.01).Conclusion The decreased expression of PKN1 in mouse cardiomyocytes can inhibit the expression of cyclin D1 protein,thereby restraining cardiomyocyte proliferation.

Implementation Strategy Analysis of Clinical Pathway in Large Public Hospitals under DRG Payment Reform / 中国医院管理

Clinical pathway has great similarity with DRG,and plays an important role in standardizing diagnosis and treatment behavior and controlling medical expenses.Based on the analysis of the relationship between DRG payment method reform and clinical pathway,taking a public hospital in Wuhan City,Hubei Province as an example,the clinical pathway implementation strategy of large public hospitals under the DRG payment method reform was explored from five aspects:management system,suitable disease types,doctor's order setting,information system,training and assessment.

Molecular Detection and Genetic Diversity of porcine Circovirus Type 3 in Commercial Pig Farms in Xinjiang Province, China.

INTRODUCTION: Porcine circovirus type 3 (PCV3) is a newly discovered porcine circovirus. The molecular characteristics and genetic evolution of PCV3 in Xinjiang province, China still being unclear, the aim of the study was their elucidation. MATERIAL AND METHODS: A total of 393 clinical samples were collected from pigs on commercial farms in nine different regions of Xinjiang and phylogenetic analysis based on full-length Cap genes was performed. RESULTS: The prevalence at farm level was 100%, while in all the tested samples it was 22.39%. Nine PCV3 strains were detected in Xinjiang province and they shared 98.9-99.3% nucleotide and 97.5-100.0% Cap gene amino acid sequence identities with other epidemic strains from China and abroad. Compared with other epidemic strains of PCV3, there were 26 base mutation sites in the Cap gene in the nine Xinjiang strains, resulting in the mutation of amino acids at positions 20, 24, 75, 77, 108, 111 and 206. Phylogenetic analysis showed that these strains can be divided into two different genetic groups, to the first of which five strains affiliated and divided between subgroups 1.1 and 1.2, and to the second of which the other four strains affiliated and similarly divided between subgroups 2.1 and 2.2. CONCLUSION: PCV3 circulates widely among commercial pig farms in Xinjiang province, China, and displays obvious genetic diversity. The results provide epidemiological information useful for the prevention and control of PCV3 infection in the pig industry.

The application value of p53 and PD-L1 detection in ultrasound-guided core needle biopsy specimens in breast cancer / 中华内分泌外科杂志

Objective:The aim of this study is to investigate the expression of p53 and PD-L1 in ultrasound-guided core needle biopsy specimens of breast cancer, and to analyze their application value.Methods:Ninety-eight patients who underwent ultrasound-guided coarse needle puncture biopsy and radical operation admitted to our hospital from Aug. 2021 to Sep. 2022 were selected as the study objects. The clinical data of patients were collected, the expression of p53 and PD-L1 in puncture biopsy specimens and radical surgical excision specimens were detected by immunohistochemical experiment, and the consistency was analyzed. Statistical test was used to analyze the relationship between the expression of p53 and PD-L1 and the pathological parameters of patients.Results:In 98 patients, the positive rate of p53 and PD-L1 in core needle biopsy specimens was 48.0% and 55.1%, respectively. The positive rate of p53 and PD-L1 in radical operative specimens was 62.2% and 61.2%, respectively. The concordance rates of p53 and PD-L1 were 63.6% ( κ=0.441, P<0.001) and 65.3% ( κ=0.505, P<0.001) between core needle biopsy specimens and radical operative specimens. Taking the results of radical operative specimens as the standard, the cases with positive expression of p53 and PD-L1 in core needle biopsy specimens were all positive in radical operative specimens, and the specificity was 100%. p53 was determined negative in 25 coarse needle biopsy specimens, however, p53 was positive in radical surgical specimens, and the false negative rate of coarse needle puncture was 49.0 %. PD-L1 was determined negative in 20 coarse needle biopsy specimens, but it was determined positive in radical operative specimens, and the false negative rate of coarse needle puncture was 41.7 %. There was no significant correlation between the consistency rate of p53 and PD-L1 expression and the number of puncture cores, the length of puncture cores, the length of invasive carcinoma and the proportion of invasive carcinoma (all P>0.05). The expressions of p53 and PD-L1 in core needle biopsy specimens were significantly correlated with tumor size, pTNM stage and Ki67 (all P<0.05), but not with age, BMI, family history, histological type or Nottingham histological grade (all P>0.05) . Conclusion:The concordance rates of p53 and PD-L1 expression between ultrasound-guided core needle biopsy specimens and radical resection specimens of breast cancer were 63.6% and 65.3%, respectively, and the specificity of positive detection results were both 100%, which has certain guiding significance for the clinical treatment of breast cancer.

Quality Difference Analysis of Raw and Steamed Products of Citri Reticulatae Pericarpium Based on Electronic Eye Technique and Chemical Fingerprint / 中国实验方剂学杂志

ObjectiveTo explore the quality differences between steamed products and raw products of Citri Reticulatae Pericarpium（CRP）. MethodThe color of steamed products and raw products of CRP was determined from the perspective of appearance by electronic eye technique， and the quality differences between them was objectively characterized by the luminous value（L*）， yellow-blue value（b*）， red-green value（a*） and total chromatic value（E*ab）. Based on this， ultra-high performance liquid chromatography（UPLC） was used to establish a fingerprint evaluation method with the mobile phase of acetonitrile（A）-0.1% formic acid aqueous solution（B） for gradient elution（0-5 min， 5%A； 5-30 min， 5%-20%A； 30-60 min， 20%-52%A）， detection wavelength at 270 nm， flow rate of 0.3 mL·min-1 and column temperature of 30 ℃. The quality differences between steamed products and raw products of CRP were compared from the perspective of chemical composition， and correlation analysis was used to reveal the correlation between the difference in appearance color and the difference in internal chemical composition. ResultAfter being steamed， L*， b* and E*ab of CRP showed an overall decreasing trend， indicating that the color of the steamed products darkened and deepened from yellow to blue but still tended to be yellow， while a* showed an overall increasing trend， indicating that the color of the steamed products tended to red. A total of 24 peaks were identified in the fingerprint profiles of raw products and steamed products of CRP， and 13 of the main peaks were identified. The precision， stability and repeatability studies showed that compared with the reference peak （peak 14， hesperidin）， the relative standard deviations（RSDs） of the relative peak area and relative retention time of the remaining peaks were<3.0%.The results of chemometric statistical analysis showed that there were some differences between raw products and steamed products of CRP， and 7 main differential components were identified， among which 5-hydroxymaltol（peak 1） and 5-hydroxymethylfurfural（peak 2） were the characteristic components of steamed products. The correlation analysis results showed that， in addition to the above two characteristic components， four components of peak 4， peak 10 （vicenin-2）， peak 23 （tangeretin） and peak 24 （5-demethylnobiletin） also correlated significantly with the color change （E*ab） of the samples （P<0.05， P<0.01）. ConclusionBefore and after steaming， not only the chemical composition changes， but also the color. Comparing the characteristic peaks of chemical composition difference and color difference before and after steaming of CRP， it is found that 5-hydroxymaltol， 5-hydroxymethylfurfural and peak 4 are common characteristic difference components， which can provide a reference for establishing the characteristic quality control method of steamed products， and quickly evaluating the quality difference between raw products and steamed products of CRP.

Characteristics and management approaches of patients admitted to isolation ward in public general hospitals under regular epidemic prevention and control of coronavirus disease 2019 / 中华传染病杂志

Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Short-term medication of dapagliflozin exacerbates CCl4 induced acute liver injury / 西安交通大学学报(医学版)

【Objective】 To investigate the role and mechanism of dapagliflozin (Dapa), a sodium glucose co-transporter 2 inhibitor, in acute liver injury. 【Methods】 Eight-week-old C57BL6/J mice were given a single intraperitoneal injection of CCl4 to induce acute liver injury. The mice were preventively given 5 mg/kg Dapa by gavage 24 h and 2 h before CCl4 injection, while those in the control group were given an equal volume of solvent gavage. After 24 h, the mice were anesthetized and sacrificed. H&E staining, plasma biochemistry, RT-qPCR, and Western blotting were used to detect the severity of liver injury and the expressions of macrophage-related genes. 【Results】 In the CCl4 group, hepatic infiltration of inflammatory cells increased, and liver and renal functions significantly deteriorated, which was further aggravated by Dapa. CCl4 could promote the expressions of M1 macrophages and fibrosis-related genes in the liver, but reduce those of M2 and antioxidant-related genes, and the latter was further inhibited by Dapa. In addition, the protein expression of arginase 1 decreased and that of SGLT2 increased after Dapa intervention, while NF-κB pathway did not change significantly, suggesting that Dapa might directly affect the energy metabolism homeostasis in the liver and aggravate acute liver injury induced by CCl4. 【Conclusion】 Dapa can exacerbate hepatic and renal damage in acute stage of liver injury, inhibit macrophages M2 polarization, and aggravate oxidative stress and inflammatory injury induced by CCl4.

Clinical application of a Kirschner wire assisted double-hook water-injection hernia needle in complicated pediatric oblique inguinal hernia / 中华实用儿科临床杂志

Objective:To explore the clinical value of single-hole laparoscopic percutaneous extraperitoneal closure operation using a Kirschner wire assisted double-hook water-injection hernia needle in treating complicated pediatric oblique inguinal hernia.Methods:The clinical data of 366 children with oblique inguinal hernia treated in the Department of Urology Surgery, Children′s Hospital of Nanjing Medical University from December 2020 to October 2021 were retrospectively analyzed.According to the surgical methods, the children were divided into the ordinary crochet needle group and the Kirschner wire assisted group.Children treated by a single-port laparoscopic double hook water-injection hernia crochet needle (309 cases) were classified into the ordinary crochet needle group.Children treated by a single-port laparoscopic Kirschner wire assisted double hook water-injection hernia crochet needle (57 cases) were included in the Kirschner wire assisted group.The independent sample t-test and rank sum test was used to compare the relevant clinical indicators between the two groups. Results:Compared with the ordinary crochet needle group, children in the Kirschner wire assisted group were younger at surgery[(2.87±1.88) years vs.(4.91±2.39) years] and had larger hernia sacs [17 303.89(8 622.49, 37 295.42) mm 3vs.9 650.97(3 849.24, 17 539.51) mm 3]. The differences in the age at surgery and hernia sac volume were statistically significant ( t=-5.407, Z=-4.218; all P<0.001). There was no significant difference in body mass index between the 2 groups ( P>0.05). Taking hernias with sac volume >10 000 mm 3 as huge hernias, there were 70.18%(40/57 cases) and 47.25%(146/309 cases) of huge hernias in the Kirschner wire assisted group and the ordinary crochet needle group, respectively.The overall operation time of the Kirschner wire assisted group was significantly longer than that of the ordinary crochet needle group[(20(15, 20) min vs.15(15, 20) min] ( Z=-2.842, P<0.05). However, the operation time for huge oblique hernias with sac volume >10 000 mm 3 was not statistically significant between the 2 groups ( P>0.05). No recurrence in both groups was found during 6-16 months of follow-up. Conclusions:For complicated oblique inguinal hernia in children with a huge hernia or obvious retroperitoneal folds at the internal ring and heavy scar adhesion between the hernia sac and abdominal wall, the insertion of a Kirschner wire can help the hernia crochet needle to traverse the vas de-ferens and spermatic cord vessels smoothly.As a single port laparoscopic operation, the Kirschner wire assisted hernia crochet needle requires no addition of trocar holes and leaves only a small surgical scar.With good feasibility and safety, it is applicable for clinical popularization.

Effects of different processing methods on the contents of the pharmacodynamic index components and antioxidant activity of Citrus aurantium / 中国药房

OBJECTIVE To stu dy the effects of different processing me thods on the contents of the pharmacodynamic index components in Citrus aurantium and their antioxidant activity. METHODS According to the general principles of 2020 edition of Chinese Pharmacopoeia （volume Ⅳ） and the relevant processing methods in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province ，the samples of C. aurantium were prepared by steaming with water ，boiling with water ，stir-frying with vinegar ，stir-frying with wine ，stir-frying with bran ，processing with bran and processing with honey. The contents of moisture and ash in different products of C. aurantium were detected. The contents of naringin and neohesperidin in different products of C. aurantium were determined by high performance liquid chromatography. The antioxidant activity of different products was investigated by DPPH and ABTS + radical scavenging experiments and the total reducing power test. RESULTS The contents of moisture ，ash，naringin and neohesperidin were in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The content of naringin in descending order was as follow ： unprocessed sample ＞sample processed with honey ＞sample processed with bran ＞sample boiled with water ＞sample stir-fried with vinegar＞sample stir-fried with wine ＞sample stir-fried with bran ＞sample steamed with water. The content of neohesperidin in descending order was as follow ：unprocessed sample ＞sample boiled with water ＞sample processed with bran ＞sample processed with honey ＞sample stir-fried with vinegar ＞sample steamed with water ＞sample stir-fried with wine ＞sample stir-fried with bran. The samples after boiling with water ，processing with bran ，and stir-fried with bran had better DPPH radicals scavenging ability （IC50 were 7.49，8.37 and 10.22 mg/mL，respectively）. The samples after boiling with water ，steaming with water ，and processed with bran had better ABTS + radicals scavenging ability （IC50 were 1.76，2.03 and 2.72 mg/mL，respectively）. In addition ， compared with sample stir-fried with wine and processed with 发。E-mail：wanglu1286@163.com honey，unprocessed sample and other processed products of C.aurantium had bet ter total reducing ability. CONCLUSIONS After processing ，the contents of the main pharmacodynamic index components in C. aurantium have been reduced ，but they were also in line with the relevant requirements in 2015 edition of Processing Specifications of Traditional Chinese Medicine in Zhejiang Province . The antioxidant ability of some processed products has been enhanced.

Discussion on the moral culture construction of medical and health industry in China based on the circular cases of violating the " nine prohibitions" / 中华医院管理杂志

Objective:To analyze the characteristics of the circular cases violating the " nine prohibitions" in recent years, so as to provide a basis for further strengthening the moral culture construction of the healthcare industry.Methods:Data came from the reported cases released on official websites of the discipline inspection committees, supervision committees and health committees at all levels in China from December 2013 to August 2021, which were identified by searching the keyword " case or report or moral culture and nine prohibitions" . Descriptive analysis and frequency analysis were conducted on the reported time, region and province, as well as the involved units, departments, persons, punishment results and case classification data of all the cases.Results:A total of 102 cases violating the " nine prohibitions" were included, of which the cases from 2014 to 2015 topped the rest, accounting for 51.96%(53 cases). Top three regions of these cases were central China, east China and southwest China, with 31 cases, 27 cases and 18 cases respectively. The units involved were mainly tertiary medical institutions, accounting for 44.12%(45 cases). More medical staff(134 people) than administrative staff(85 people) were involved in the cases. The largest number of cases was receiving kickbacks, with 52 cases(50.98%). The punishment results of cases included judicial procedures(76 people), Party discipline and government discipline punishment(67 people) and organizational punishment(76 people).Conclusions:Moral culture problem in China′s healthcare sector is characterized in wide coverage, complexity, comprehensiveness and long-term. Relevant authorities should keep up their efforts in enhancing the awareness of medical workers, improving the synergy mechanism in this regard, and strengthening the internal management of medical institutions.

Clinical characteristics and mechanism of COVID-19 vaccine-related myocarditis / 西安交通大学学报(医学版)

【Objective】 To investigate the clinical characteristics and potential mechanism of coronavirus disease 2019 （COVID-19） vaccine-related myocarditis. 【Methods】 We made a systematic literature retrieval based on PubMed to search for all reports on COVID-19 vaccine-related myocarditis published by August 31， 2021. A total of 29 reports involving 71 patients with myocarditis were enrolled after screening. The patients’ demographic data， vaccination， clinical manifestations， biochemical and imaging results， treatments， and outcomes were extracted and summarized. The patients were divided into prior COVID （n=12） and non-prior COVID （n=59） according to their previous medical history. 【Results】 COVID vaccine-related myocarditis was more common in men （91.5%） and after the second dose of mRNA vaccine （81.7%）. The average time to onset was 3 （1， 25） days， and the main symptoms included chest pain （94.4%）， fever （45.1%）， myalgia （26.8%）， and shortness of breath （16.9%）. Abnormal troponin level was present in almost all the patients， with a common elevation of C-reactive protein. Non-steroidal anti-inflammatory drugs and colchicine were widely used in clinical treatment， and the symptoms of one-fifth of the patients were relieved after symptomatic therapy， with 1 to 2 weeks’ length of hospital stay. However， the risk of vaccine-related myocarditis was significantly increased in patients with previous COVID-19 infection， which was more common after the first dose of vaccine （58.3%） other than the second dose. And the clinical symptoms and outcomes were somewhat different from those without COVID-19 infection previously. 【Conclusion】 Myocarditis is one of the serious adverse events related to COVID-19 vaccine， with an overall relatively low incidence， mild clinical severity， and favorable prognosis. Vaccine-related myocarditis may be a combined result of primed immune system and individual susceptibility after infection with COVID-19.

Correlation of platelet/albumin ratio, platelet/hemoglobin ratio and C-reactive protein/albumin ratio with diabetes in a population-based study / 西安交通大学学报(医学版)

【Objective】 To investigate the association of platelet/albumin ratio （PAR）， platelet/hemoglobin （PHR） and C-reactive protein/albumin （CAR） with diabetes mellitus. 【Methods】 Based on the data of China Health and Nutrition Survey （CHNS2009）， with gender and age matched by their ID， a total of 8 258 individuals with serological test results were finally included and were divided into diabetes group and control group according to the fasting blood glucose and HbA1c， and then the blood lipid and blood cell changes， PAR， PHR and CAR differences between groups were compared， and the correlation analysis of diabetes was performed. 【Results】 Compared with those in the control group， serum uric acid， total cholesterol， triacylglycerol and low-density lipoprotein cholesterol （LDL-C） were significantly increased in diabetes group， while high-density lipoprotein cholesterol （HDL-C） was significantly decreased. Besides， there was no significant difference in PAR or PHR between the two groups， while CAR was significantly increased in diabetes （0.48±0.18 vs. 0.08±0.23， P<0.001）， and was positively correlated with the levels of fasting glucose （r=0.181 8， P<0.001）， HbA1c （r=0.186 6， P<0.001）， and HOMA-IR （r=0.188 1， P=0.003）. However， CAR was not an independent risk factor for diabetes. In addition， increased red blood cell count （B=1.324， 95% CI： 1.182-1.483， P<0.001） and leukocytes count （B=1.230， 95% CI： 1.166-1.298， P<0.001） may be independent risk factors for the incidence of diabetes. 【Conclusion】 CAR is correlated with diabetes mellitus， but it is not an independent risk factor. Dyslipidemia， elevated leukocytes and red blood cell counts may be independent risk factors for diabetes， but further study is needed.

Network pharmacology explores the potential mechanism of Salvia miltiorrhiza in the treatment of coronary heart disease complicated with depression or anxiety disorder / 西安交通大学学报(医学版)

【Objective】 To explore the potential mechanism of Salvia miltiorrhiza and its active monomers in patients with coronary heart disease （CHD） complicated with depression or anxiety disorder based on network pharmacology. 【Methods】 We collected the clinical data of 147 patients with CHD admitted to our hospital from March to April 2021 and investigated biochemical examination， drug treatment and the use of Chinese herbal compound. The downstream targets of active monomers of Salvia miltiorrhiza were screened based on TCMSP， PubChem and SwissTargetPrediction databases， and depression or anxiety-related genes were mining in OMIM， GeneCards and TTD databases. Protein-protein interaction network and GO and KEGG gene enrichment analyses were performed by matching Chinese herbal compound with disease targets. Chinese herbal compound-target-disease network was built by Cytoscape. 【Results】 Shuxuening （44.9%）， Salviae miltiorrhiza （27.9%）， and Sofren injection （21.8%） were the most commonly used Chinese herbal or injections in the clinical treatment of CHD， and there was no difference in the frequency of use between genders. Network pharmacology showed that the active components of Salvia miltiorrhiza might act on neuroactive ligand-receptor binding， 5-hydroxytryptamine synapses and dopaminergic synapses and participate in the regulation of neurotransmitter transport， dopamine and catecholamine metabolism and stress response. Target-disease network analysis showed that many active components of Salvia miltiorrhiza interacted with catechol-O-methyltransferase， monoamine oxidase， 5-hydroxytryptamine receptor and opioid receptor， which may be the potential targets of Salvia miltiorrhiza in improving depression and anxiety. 【Conclusion】 Salvia miltiorrhiza is involved in the regulation of neurotransmitters and synaptic activities， thus making it a potential drug for the clinical treatment of CHD complicated with depression and anxiety disorder.