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This paper reviewed the development of "Internet + nursing service" at home and abroad, the needs of "Internet + nursing service" for the elderly with disabilities at home, and the factors affecting the use of "Internet + nursing service" by the elderly with disabilities at home. The aim was to provide reference for the further development of "Internet + nursing service" in the elderly with disability at home.
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OBJECTIVE To provide a reference for further improvement of the essential medicine system. METHODS Statistical analysis method and comparative analysis method were used to explain the necessity of coordination between the two systems from the direct correlation and indirect impact of centralized volume-based procurement on the essential medicine system at the present stage. The relevant suggestions were put forward for the development of the essential medicine system in the new era from the perspective of improving institutional synergy. RESULTS & CONCLUSIONS There was a direct correlation between the policy of centralized procurement and the essential medicine system in terms of policy objectives and medicines selection. However， it also indirectly affects the use of essential medicines in medical institutions through production and supply， coincidence degree between the essential medicine list and the selected variety， and the consistency evaluation of generic drugs. It is suggested that in the selection of essential medicine list in the future， priority should be given to the selection of varieties through centralized procurement， and improve the drug supply guarantee capacity under the dual policy linkage； at the same time， incentive assessments for the allocation and use of essential medicines by various entities should be further strengthened to promote the further improvement and development of the essential medicine system.
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Objective To ensure the accuracy of gamma spectrometer in our laboratory for the analysis of radionuclides in samples and to improve the laboratory personnel’s ability to perform analyses of radionuclides. Methods Our laboratory had continuously participated in the national assessments of gamma spectrometry of radionuclides organized by the Chinese Center for Disease Control and Prevention. The samples were measured by a high-purity germanium gamma spectrometer (GEM-MX7080P4). An analysis was performed on the results of the gamma spectrometry assessments from 2014 to 2021. Results Our laboratory had an overall qualified rate of 100% (8/8) and an overall excellent rate of 39% (3/8) in the gamma spectrometry assessments from 2014 to 2021. The distribution ranges of RD, Z, U, and Urel for 28 measurements involving radionuclides 208Tl, 228Ac, 232Th, 40K, 238U, and 137Cs were −11.82% to 5.97%, −0.59 to 0.30, 0.02 to 0.92, and 4.33% to 10.49%, respectively. Conclusion The methods used in our laboratory for gamma spectrometry of radionuclides are accurate and the testing reports issued by our laboratory are reliable.
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Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation
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The female infant in this case study was admitted to the hospital 4 hours after birth due to preterm birth and respiratory distress. On the third day after birth, peripherally inserted central venous catheter (PICC) catheterization was performed. On day 42, thrombus was found at the entrance of the right atrium from the inferior vena cava during a cardiac ultrasound, and it was considered to be related to PICC placement. Low-molecular-weight heparin and urokinase were given. After two weeks of treatment, ultrasonic monitoring showed thrombus shrinkage. No bleeding or pulmonary embolism occurred during the treatment. The patient discharged after improvement. This article mainly introduces a multidisciplinary team approach to diagnosis and treatment of PICC-related thrombosis in neonates.
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Infant, Newborn , Infant , Humans , Female , Central Venous Catheters/adverse effects , Premature Birth , Dyspnea , Echocardiography , Catheterization, PeripheralABSTRACT
In order to study the analgesic effect of Shaoyao Gancao Decoction, this paper discussed material basis and mechanism from the perspective of macromolecules in traditional Chinese medicine. Inspired by the phenomenon of turbidity after boiling Chinese medicine, this experiment took Shaoyao Gancao Decoction as the research object to study the formation process of precipitation during boiling. The results showed that aggregates with a certain shape were formed in the solvent during the boiling process, and the precipitate was obtained by standing and centrifuging. Analysis found that the precipitation was mainly composed of small molecules such as paeoniflorin, albiflorin, liquiritin, glycyrrhizic acid, isoliquiritin and gallic acid, and macromolecules such as protein and polysaccharide. The composition of precipitate was consistent with that of Shaoyao Gancao Decoction, but the analgesic effect of Shaoyao Gancao Decoction after removing the precipitate was significantly reduced. Based on these results, we isolated small molecular compounds, polysaccharides and protein from Shaoyao Gancao Decoction and their contents are 60.4, 700.7 and 207.2 mg·g-1 respectively. We get the ratio, polysaccharide: small molecule = 11.6∶1, protein: small molecule = 3.4∶1, the precipitate is prepared in the state of boiling. The characterization results showed that the particle size of the precipitate will change significantly after co-heating, and the content determination results showed that the content of the six small molecular compounds which was free in solvent was significantly reduced after the formation of the precipitate. The acetic acid writhing experiment proved that the precipitate has a good analgesic effect, and effectively reduced the levels of inflammatory factors prostaglandin E2 and nitric oxide, and increased the level of anti-inflammatory factor interleukin-10. These results proved that the precipitate in Shaoyao Gancao Decoction is an important material basis for analgesic effect, and macromolecules such as protein and polysaccharide are the main components of the precipitate. The study of macromolecules in the precipitate of Shaoyao Gancao Decoction not only provides new ideas and methods for elucidating the pharmacodynamic material basis of Shaoyao Gancao Decoction, but also provides a reference for analyzing the scientificity of traditional decoction.
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Objective To investigate the role of angiotensin-converting enzyme (ACE) in the reproduction of Culex pipiens pallens, so as to provide insights into selection of targets for controlling mosquito vector populations. Methods Cx. pipiens pallens was collected from Tangkou County, Shandong Province in 2009. Female and male mosquitoes were selected at 72 hours post-eclosion, and quantitative real-time reverse transcription PCR (qPCR) assay was used to detect the expression of ACE gene in the whole body and reproductive tissues of male mosquitoes and fertilized female mosquitoes before (0 h) and after blood meals (24, 48, 72 h), respectively. Then, 150 female and 150 male mosquitoes at 0 to 4 hours post-eclosion were selected and divided into the wild-type group (WT group), small interfering RNA-negative control group (siNC group) and small interfering RNA-ACE group (siACE group), of 50 mosquitoes in each group. Mosquitoes in the WT group were given no treatment, and mosquitoes in the siNC and siACE groups were given microinjection of siNC and siACE into the hemolymph at a dose of 0.3 μg per mosquito. The knockdown efficiency was checked using qPCR assay, and the reproductive phenotype of mosquitoes was observed. Results The relative ACE gene expression was higher in the whole body of male mosquitoes (5.467 ± 1.006) relative to females (1.199 ± 0.241) (t = 5.835, P = 0.004) at 72 h post-eclosion, and the highest ACE expression was seen in reproductive tissues of male mosquitoes (199.100 ± 24.429), which was 188.3 times higher than in remaining tissues (1.057 ± 0.340) (t = 6.602, P = 0.002). Blood meal induced high ACE expression in all body tissues of fertilized female mosquitoes, with peak expression at 24 h after blood meals (14.957 ± 2.815), which was 14.8 times higher than that before blood meals (1.009 ± 0.139) (P = 0.002). The transcriptional level of ACEs continued to increase in the ovaries of female mosquitoes after blood meals during the vitellogenesis phase, peaking at 48 h after blood meals (5.500 ± 0.734), which was 5.1 times higher than that before blood meals (1.072 ± 0.178) (P = 0.002). Small RNA interference targeting ACE resulted in a 57.2% reduction in ACE expression in female mosquitoes in the siACE group (0.430 ± 0.070) relative to the siNC group (1.002 ± 0.070) (P = 0.001), and a 41.1% reduction in male mosquitoes in the siACE group (0.588 ± 0.067) relative to the siNC group (1.008 ± 0.131) (P = 0.016). Knockdown of ACE expression resulted in a 48.0% decrease in the number of eggs laid by female mosquitoes in the siACE group [(94.000 ± 27.386) eggs] relative to the siNC group [(180.800 ± 27.386)] (P < 0.001), and a 45.0% decrease in the number of eggs laid by wild female mosquitoes mated with males in the siACE group [(104.500 ± 20.965) eggs] relative to the siNC group [(190.050 ± 10.698) eggs] (P < 0.001). Conclusions Reduced ACE expression may inhibit the fecundity of male and female mosquitoes, and ACE may be as a potential target for mosquito vector population suppression.
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Objective@#: The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. @*Methods@#: A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. @*Results@#: A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). @*Conclusion@#: The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.
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【Objective】 To compare the efficacy of radiofrequency thermocoagulation and pulsed radiofrequency for the ganglion impar in treating primary perineal pain. 【Methods】 We analyzed 79 patients with primary perineal pain who underwent radiofrequency thermocoagulation (group A) and pulsed radiofrequency (group B) in the ganglion impar from January 2020 to March 2022. VAS, excellent and good rates, sleep quality, postoperative medication usage, complications, and recurrence were evaluated before and 24 h, 1 W, 1 M, 3 M and 6 M after operation. The differences between the two groups were compared. 【Results】 The VAS score of group A gradually decreased at each level after operation, and the VAS score of group B gradually increased after 24 hours of operation. The differences between the two groups began to appear 1 week after operation, and the differences further increased with the extension of time (P<0.001). In six months after follow-up, the excellent and good rates of group A (86%) was significantly higher than that of group B (22%). In addition to postoperative perineal skin numbness, group A was superior to group B in improving sleep, postoperative oral medication (pregabalin and opioids), and disease recurrence (P<0.05). 【Conclusion】 Radiofrequency thermocoagulation for the ganglion impar can improve the quality of life by reducing pain, improving the excellent and good rates, improving sleep, and reducing recurrence a medication. The effect is better than that of pulsed radiofrequency.
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Objective:To analyze the relationship between allergen reactivity, atopic disease history and clinical features in patients with chronic inducible urticaria (CIndU) .Methods:A retrospective analysis was conducted on clinical data and follow-up results from 168 patients with CIndU in the Department of Dermatology, Southwest Hospital of Army Medical University from June 2014 to June 2015. Associations were analyzed between allergen reactivity, atopic disease history and clinical characteristics (including patient global assessment [PGA] scores, pruritus intensity, dermatology life quality index [DLQI], proportions of cases with complicated angioedema, natural course, etc.) in patients with different CIndU subtypes. Chi-square test, Mann-Whitney U test and Kaplan-Meier survival analysis were used for statistical analysis. Results:Among the 168 patients with CIndU, 117 were diagnosed with symptomatic dermographism (SD) , 32 with cold contact urticaria (CCU) , 5 with heat contact urticaria (HCU) , and 14 with cholinergic urticaria (CholU) ; there were 46 (39.3%) , 14 (43.8%) , 3, and 9 patients with positive skin prick test (SPT) among the patients with SD, CCU, HCU and CholU respectively, and no significant difference was observed in the positive rate of SPT among patients with different CIndU subtypes ( χ2 = 3.86, P = 0.283) . The SPT-positive CIndU patients showed significantly increased PGA scores, pruritus scores, DLQI scores and proportions of cases with complicated angioedema compared with the SPT-negative patients (all P<0.05) ; the CIndU patients with a personal or family history of atopic diseases also showed significantly increased PGA and DLQI scores compared with those without (both P < 0.05) . For different CIndU subtypes, the pruritus scores, PGA scores, DLQI scores, and proportions of cases with complicated angioedema were significantly higher in the SPT-positive SD patients than in the SPT-negative SD patients (all P < 0.05) ; the DLQI scores were significantly higher in the SPT-positive CholU patients than in the SPT-negative CholU patients ( Z = -2.28, P = 0.019) ; the pruritus scores were significantly higher in the CCU patients with a personal or family history of atopic diseases than in those without ( Z =-2.41, P = 0.022) . Conclusion:The allergen reactivity and atopic disease history of CIndU patients were associated with disease severity, pruritus intensity, quality of life, and the proportion of cases with complicated angioedema, but their relationship with the natural course of CIndU needs to be confirmed by further studies.
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Objective:To explore the present state of radiation protection in an operational large-sized irradiation facility and the distribution of incurred radiation doses in the controlled area under abnormal conditions, and to analyze the acompanied radiation risk.Methods:With an irradiation facility in operation as the research object, the radiation doses were measured using AT1121 X and gamma dose rate meters for the soruce both in working and storage. Thermoluminescent dosimeters (TLDs) were used to measure the dose distribution in an irradiation field under abnormal conditions. The radiation safety features were checked against the several relevant national standards, with the radiation risks evaluated.Results:The radiation dose rates were in the range of 0.09-0.11 μSv/h, lower than the environmental background level whether in storage or working. Under abnormal working conditions, the radiation dose values from high to low were 1.0-101.3 Sv, 32.7-514.0 mSv and 8.7-183.2 μSv in the irradiation field, respectively. At the outside maze, the doses were close to the background level.Conclusions:The protection features of the irradiation facility meet the requirements of the relevant national standards. Under abnormal conditions, radiation could cause serious damages to the persons staying in the irradiation field. These persons were suggested to access to maze as soon as possible to reduce the exposure time, and activate the emergency protection equipments to deescalate the 60Co source onto the well.
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Objective:To investigate the effects of bandaging methods on breast cancer associated lymphoedema.Methods:By simple random sampling method, a total of 90 cases of breast cancer associated lymphoedema patients who received complex decongestion therapy in Hubei Cancer Hospital from May 2020 to My 2021 were randomly assigned to experimental group and control group, with 45 cases in each group. All patients received complex decongestion therapy. At the pressure bandage stage, the control group received figure-of-eight shape bandaging methods, the experimental group implemented modified bandaging methods: the figure-of-eight shape bandaging methods was used below the elbow joint, the spiral bandaging methods was used above the elbow joint. The arm circumference of affected limb, extracellular water/total body water ratio, general comfort questionnaire, bandage loosening rate as well as bandage loss was compared between two groups.Results:At 20 days after treatment, the arm circumference of affected limb in L 3, L 4 were (20.69 ± 2.06) cm, (25.76 ± 3.79) cm and extracellular water/total body water ratio was (10.15 ± 2.49)% in the experimental group, which were lower than those in the control group (21.97 ± 3.45) cm, (27.33 ± 3.25) cm and (11.67 ± 3.12)%, the differences were significant ( t=2.13, 2.11 and 2.56, all P<0.05); the physiological demension scores and total general comfort questionnaire scores were (11.07 ± 2.09) points and (81.71 ± 5.65) points in the experimental group, which were higher than those in the control group (8.36 ± 2.28) points and (77.29 ± 7.52) points, the difference were statically significant ( t=5.88 and 3.16, P<0.05). The bandage loosening rate was 2.2% in the experimental group, 6.7% in the control group, there was no significant difference between two groups ( χ2=1.05, P>0.05). The average bandage loss was (3.47 ± 0.53) rolls in the experimental group, which was lower than that in the control group (3.79 ± 0.40) rolls, the difference was statically significant ( t=3.28, P<0.01). Conclusions:Modified bandaging methods can decrease breast cancer associated lymphoedema, improve the degree of patient comfort and reduce bandage usage.
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Xieriga-4 Decoction, composed of dried rhizomes of Curcumae longae, barks of Phellodendron chinense or Phellodendron amurense, fruits of Cardenia jasminoides, and fruits of Tribulus terrestris, is a famous prescription of traditional Mongolian medicine for the treatment of urinary system diseases such as frequent urination, urgent urination, urine occlusion, hematuria, bladder irritation and pain. This paper reviewed Xieriga-4 Decoction from the aspects of historical description, prescription principle, chemical components, pharmacology, clinical application and quality control.
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ObjectiveTo explore difference in the mechanism of Shoutaiwan， a representative kidney-tonifying and abortion-preventing formula， and Juyuanjian， a typical spleen-invigorating and abortion-preventing formula in reversing the pathology of decidua of spontaneous abortion （SA） patients and to expound the connotation of "uterine collaterals connecting kidney" and "fetal collaterals connecting spleen" theory. MethodThe targets of SA were retrieved from GeneCards， followed by gene ontology-biological process （GO-BP） annotation. Based on Cytoscape and previous research， the main processes and core targets were screened out. High-performance liquid chromatography-mass spectrometry （HPLC-MS） was used to identify the potential active components of Shoutaiwan and Juyuanjian and the regulatory networks were constructed. SA was induced in rats and the model rats were treated with Shoutaiwan and Juyuanjian at the same unit. Hematoxylin and eosin （HE） staining， transmission electron microscopy （TEM）， enzyme-linked immunosorbent assay （ELISA）， immunohistochemistry （IHC）， immunofluorescence （IF）， and other methods were employed to verify the mechanisms against miscarriage. ResultThe dysregulation of cell adhesion， inflammatory response， cell death， and angiogenesis was the core pathological process of SA. A total of 13 potential specific active components of Shoutaiwan and 14 active components of Juyuanjian were screened out. The regulatory networks showed that the potential active components of the two prescriptions modulated vascular endothelial growth factor （VEGF）， interleukin （IL）-2， estrogen receptor （ESR）-1， matrix metalloproteinase-9 （MMP-9）， and other targets to regulate the pathological process of SA. The two can significantly improve the pregnancy rate and the integrity rate and blood supply of decidua cells， control the apoptosis morphology and the expression of estrogen （E2）， progesterone （P）， and its receptor， and down-regulate the expression of MMP-2， MMP-9， IL-2， and IL-6 in decidua tissue of SA rats. At the same time， they up-regulated the expression of anti-apoptotic protein B-cell lymphoma-2 （Bcl-2） and IL-4. Shoutaiwan significantly up-regulated the expression of VEGF， and Juyuanjian significantly down-regulated the expression of E-cadherin （E-Cad）. ConclusionBoth Shoutaiwan and Juyuanjian regulate the core pathological process of SA to prevent miscarriage. At the same unit， Shoutaiwan is overall superior to Juyuanjian. Shoutaiwan is better than Juyuanjian in regulating angiogenesis and Juyuanjian is superior to Shoutaiwan in regulating cell adhesion. This conclusion can partly explain the biological basis of "treating the same disease with different methods"， and provide objective data reference for the identification of quality marker （Q-marker） of anti-miscarriage Chinese medicine and further study of formula-syndrome metabolome.
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ObjectiveTo investigate the current status of sleep quality among adult residents in urban areas of Mianyang， and to explore the influencing factors. MethodsA cross-sectional survey was conducted on 126 adult residents from three communities in Mianyang. The selected individuals were assessed using self-made general information questionnaire， Pittsburgh Sleep Quality Index （PSQI）， the sleep-hygiene awareness activities subsection and sleep-hygiene practice sections of Sleep Hygiene Awareness and Practice （SHAP）. Then the sleep quality among residents of different demographic characteristics， sleep-hygiene awareness activities and sleep-hygiene practices was compared， meantime， the influencing factors of sleep quality were screened via multiple linear regression model. ResultsThe PSQI score was （7.51±4.05） among urban adults in Mianyang. Correlation analysis yielded that the sleep-hygiene awareness score was positively correlated with the daytime dysfunction dimension score in PSQI （r=0.232， P=0.009）， and the sleep-hygiene habit score was positively correlated with PSQI score， the dimension scores of sleep latency， sleep quality， sleep duration， use of sleeping medication and daytime dysfunction （r=0.188~0.362， P<0.05 or 0.01）. Regression analysis showed that sleep-hygiene habit was the influencing factor of sleep quality （P<0.01）. ConclusionThe sleep quality among adult residents in urban areas of Mianyang needs to be improved， moreover， sleep-hygiene habit is a key factor affecting sleep quality.
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This article aims to provide a review of the domestic and foreign studies on the quality indicators for evaluating the psychiatric nursing care in recent years. According to Donabedian model， the research progress of quality indicators for evaluating the psychiatric nursing care were described from the three dimensions of structure quality， process quality and outcome quality. This paper summarizes the status of the research， points out the shortcomings of existing research， and provides references for the future research on the quality indicators for evaluating the psychiatric nursing care.
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Objective: To explore the efficacy and safety of real-world eribulin in the treatment of metastatic breast cancer. Methods: From December 2019 to December 2020, patients with advanced breast cancer were selected from Beijing Chaoyang District Sanhuan Cancer Hospital, Shandong Cancer Hospital, Peking University Cancer Hospital, Baotou Cancer Hospital, Shengjing Hospital Affiliated to China Medical University, and Cancer Hospital of Chinese Academy of Medical Sciences. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox regression model was used for multivariate analysis. Results: The median progression-free survival (PFS) of 77 patients was 5 months, the objective response rate (ORR) was 33.8%, and the disease control rate (DCR) was 71.4%. The ORR of patients with triple-negative breast cancer was 23.1%, and the DCR was 57.7%; the ORR of patients with Luminal breast cancer was 40.0%, and the DCR was 77.8%; the ORR of patients with HER-2 overexpression breast cancer was 33.3%, and the DCR was 83.3%. ORR of 50.0% and DCR of 66.7% for patients treated with eribulin as first to second line treatment, ORR of 29.4% and DCR of 76.5% for patients treated with third to fourth line and ORR of 28.6% and DCR of 71.4% for patients treated with five to eleven line. The ORR of patients in the eribulin monotherapy group was 40.0% and the DCR was 66.0%; the ORR of patients in the combination chemotherapy or targeted therapy group was 22.2% and the DCR was 81.5%. Patients with a history of treatment with paclitaxel, docetaxel, or albumin paclitaxel during the adjuvant phase or after recurrent metastasis had an ORR of 32.9% and a DCR of 69.9% when treated with eribulin. The treatment efficacy is an independent prognostic factor affecting patient survival (P<0.001). The main adverse reactions in the whole group of patients were Grade Ⅲ-Ⅳ neutrophil decline [29.9% (23/77)], and other adverse reactions were Grade Ⅲ-Ⅳ fatigue [5.2% (4/77)], Grade Ⅲ-Ⅳ peripheral nerve abnormality [2.6% (2/77)] and Grade Ⅲ-Ⅳ alopecia [2.6% (2/77)]. Conclusions: Eribulin still has good antitumor activity against various molecular subtypes of breast cancer and advanced breast cancer that has failed multiple lines of chemotherapy, and the adverse effects can be controlled, so it has a good clinical application value.
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Female , Humans , Breast Neoplasms/pathology , Furans/adverse effects , Ketones/adverse effects , Paclitaxel/adverse effects , Treatment Outcome , Triple Negative Breast Neoplasms/drug therapyABSTRACT
Objective:To compare the clinical effects of bridge combined internal fixation system and locking plate system in treating closed humeral shaft fracture.Methods:From August 2017 to August 2020, there were 45 patients with closed humeral shaft fracture treated with surgery. Bridge combined internal fixation system were performed in 19 patients (bridge combined group, aged 38.3±11.9, range 21-72 years), including 13 males and 6 females. Further, there were 26 patients underwent locking plate system (locking plate group, aged 41.2±14.7, range 20-79 years), including 20 males and 6 females. The operation was performed by minimal invasive percutaneous osteosynthesis with fixators. The patients were followed up every 4 weeks. The fracture healing condition was recorded. Shoulder function was assessed according to University of California at Los Angeles (UCLA) shoulder rating scale and elbow function was assessed according to Mayo elbow performance score (MEPS).Results:The follow-up duration of all patients were 14.2±4.7 (range 10-32) months. All wound were healed completely. The operation duration in bridge combined group (68.1±12.5 min) was longer than that in locking plate group (56.3±11.6 min) ( t=3.32, P=0.002). The blood loss of bridge combined group and locking plate group were 112.6±20.2 ml and 104.2±14.1 ml, respectively ( t=1.65, P=0.107). The volume of drainage of bridge combined group was 68.4±16.2 ml and that of locking plate group was 73.1±14.9 ml ( t=1.00, P=0.323). The hospitalization time of bridge combined group was 9.7±2.3 d and the locking plate group was 9.4±1.9 d ( t=0.57, P=0.573). All above parameters had no statistical significance between the two groups. Fracture nonunion occurred in 1 of 19 patients in bridge combined group. The fracture healing time was 15.3±4.3 weeks in another 18 cases, while that of locking plate group was 15.9±3.9 weeks ( t=0.47, P=0.638). At 4-weeks postoperative follow-up, the UCLA shoulder score (18.1±3.9) and the MEPS (55.4±6.8) of bridge combined group were lower than those of locking plate group ( P<0.05). At 8-weeks postoperative follow-up, the shoulder score (26.2±4.3) and the MEPS (70.9±6.5) of bridge combined group were lower than those of locking plate group ( P<0.05). At 12-weeks postoperative follow-up, the UCLA shoulder score (33.6±1.0) and the MEPS (91.0±3.7) of bridge combined group had no statistical difference with those of locking plate group ( P>0.05). Conclusion:The bridge combined internal fixation system could provide personalized and multidimensional fixation according to the fracture type. The clinical effects of bridge combined internal fixation system on humeral shaft fracture are similar to the locking plate system at 12 weeks postoperatively. However, the operation duration of bridge combined system is longer and with increased the risk of nonunion.
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By consulting ancient Chinese herbal medicines and medical books， combined with modern documents， the textual research of Polygonati Rhizoma has been conducted to verify the name， origin， bitter-flavored Polygonatum species， Latin name evolution， origin， quality evaluation， harvesting and processing changes， so as to provide reference and basis for the development and utilization of the famous classical formulas. Through textual research， it can be seen that there are many other names for Polygonati Rhizoma， and Huangjing is the correct name since Mingyi Bielu. Based on the original research， it is concluded that P. sibiricum and P. cyrtonema were the mainstream of Polygonati Rhizoma before the Tang dynasty， and P. kingianum was added in the Qing dynasty. According to the shape of medicinal materials， these Polygonatum species were called Jitou Huangjing， Jiangxing Huangjing and Dahuangjing. The harvest time of Polygonati Rhizoma is spring and autumn. After harvest， it is steamed and dried in the sun， and its processing method is mainly "nine steaming and nine storms". Bitter-flavored Polygonatum is mainly P. cirrhifolium， P. zanlanscianense， P. curvistylum and P. verticillatum， which are not suitable for medicine. Based on textual research， it is recommended that when developing famous classical formulas and health products with Polygonati Rhizoma as the main raw material， the origin and producing area should be clear and fixed， and P. sibiricum or P. cyrtonema with clear origin should be used. It is necessary to conduct germplasm survey and sampling in the producing area， establish a planting base and a traceability system for Polygonati Rhizoma， in order to control the quality and stabilize the efficacy of the products. The processing method of Polygonati Rhizoma can be determined according to the product function positioning.
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By consulting ancient herbal medicines and medical books， combined with modern documents and field investigations， the textual research of Pheretima has been conducted to verify the name， origin， producing area， quality， harvesting and processing changes， and sort out the relationship of origin between ancient and modern times， so as to provide reference and basis for the development and utilization of the related famous classical formulas. Through textual research， it is known that there are many aliases for Pheretima， the rectification of name was "Qiuyin" or "Baijing Qiuyin" in materia medica books. In the Song dynasty and later prescription books， the prescription name is mostly Dilong. From the beginning of Yaowu Chuchanbian （《药物出产辨》）， Dilong was used as the rectification of name. It is widely distributed in our country， which is produced all over the country and mostly wild. According to ancient Pheretima with "Baijing Dilong"， "Jingbai Shenzi" and "Datiao" as the principles of medicine， combined with historical origin， producing area and easy access， it is confirmed that Pheretima used in ancient times to the present is mainly Pheretima aspergillum， and it also has many other Qiuyin as Pheretima for medicinal purposes. Chinese Pharmacopoeia has unified the origin of the Pheretima since the 1995 edition based on historical origins and actual harvesting conditions. The medicinal material processed by P. aspergillum was called Guangdilong， and the medicinal materials processed by P. vulgaris， P. guillelmi and P. pectinifera were called Hudilong. Since then， all the herbal books published in the future are in line with Chinese Pharmacopoeia that was implemented at that time. The authentic production areas of Guangdilong are Guangdong and Guangxi， and the authentic production areas of Hudilong is Jiangsu， Shanghai， Zhejiang and Anhui. The Guangdilong produced in Guangdong and Guangxi has the best quality. After harvesting， remove the soil and offal， wash and dry. Clinically cut into sections for medicine， or prepare medicine according to prescription. The Pheretima in ancient used "Baijing Dilong"， "Jingbai Shenzi" and "Datiao" as the mainstream quality evaluation standards. According to historical origins， P. aspergillum should be the main source of Pheretima， and its quality is better than other species. Therefore， it is recommended that Pheretima in Shentong Zhuyutang use P. aspergillum， which is produced in Guangdong， Guangxi and other places. After harvest， the abdomen was opened in time to remove the viscera and sediment， washed and dried.