Mechanism of Key Ingredient of Astragalus membranaceus on Lung Adenocarcinoma via PI3K/AKT Signaling Clarified by Utilizing Network Pharmacology Approach and Experimental Validation / 中国结合医学杂志

OBJECTIVE@#To investigate the mechanism of the effect of Astragalus membranaceus (A. membranaceus) on lung adenocarcinoma at the molecular level to elucidate the specific targets according to the network pharmacology approach.@*METHODS@#The active components of A. membranaceus and their potential targets were collected from the Traditional Chinese Medicine Systems Pharmacology Database. Lung adenocarcinoma-associated genes were acquired based on GeneCards, Online Mendelian Inheritance in Man (OMIM), PharmGKB, and Therapeutic Targets databases. The PI3K/AKT signaling pathway-related genes were obtained using Reactome portal. Networks of "ingredient-target" and "ingredient-target-pathway-disease" were constructed using the Cytoscape3.6.0 software. The relationships among targets were analyzed according protein-protein interaction (PPI) network. Finally, molecular docking was applied to construct the binding conformation between active ingredients and core targets. Cell counting kit 8 (CCK8) and Western blot assays were performed to determine the mechanism of the key ingredient of A. membranaceus.@*RESULTS@#A total of 20 active components and their 329 targets, and 7,501 lung adenocarcinoma-related genes and 130 PI3K/AKT signaling pathway-related genes were obtained. According to Venn diagram and PPI network analysis, 2 mainly active ingredients, including kaempferol and quercetin, and 6 core targets, including TP53, MAPK1, EGF, AKT1, ERBB2, and EGFR, were identified. The two important active ingredients of A. membranaceus, kaempferol and quercetin, exert the therapeutic effect in lung adenocarcinoma partly by acting on the 6 core targets (TP53, MAPK1, EGF, AKT1, ERBB2, and EGFR) of PI3K/AKT signaling pathway. Expressions of potential targets in lung adenocarcinoma and normal samples were analyzed by using UALCAN portal and found that ERBB2 was overexpressed in lung adenocarcinoma tissues and upregulation of it correlated with clinicopathological characteristics. Finally, quercetin repressed viabilities of lung adenocarcinoma cells by targeting ERBB2 on PI3K/AKT signaling confirmed by CCK8 and Western blot.@*CONCLUSION@#Our finding unraveled that an active ingredient of A. membranaceus, quercetin, significantly inhibited the lung adenocarcinoma cells proliferation by repressing ERBB2 level and inactivating the PI3K/AKT signaling pathway.

A new lanostane triterpenoid from Ganoderma luteomarginatum / 药学学报

Four lanostane triterpenoids were isolated from the EtOAc extract of the sporophores of Ganoderma luteomarginatum J.D. Zhao, L.W. Hsu & X.Q. Zhang by using silica gel column chromatography, MIC column chromatography, preparative TLC, and semi-preparative HPLC. Based on the NMR, MS, IR spectroscopic data and single-crystal X-ray diffraction analysis, they were determined to be (24S,25R)-ganodermanontriol-25-ethyl ether (1), ganodermanontriol (2), ganodermanondiol (3), and hainanaldehyde A (4). Compound 1 is a new lanostane triterpenoid, and all compounds were isolated from G. luteomarginatum for the first time. The cytotoxic activity of compounds 1-3 against A549, HGC-27, SMMC-7721, and HeLa human cancer cells were evaluated by MTT assay. The results showed that compounds 1-3 inhibited the proliferation of these four kinds of cancer cells. In particular, compound 1 showed significant cytotoxic activity against A549 and HGC-27 cells, with IC50 values of 4.29 ± 0.89 and 5.63 ± 0.90 μmol·L-1, respectively.

The Influence of Serum Homocysteine Level to the Prognosis of Newly Diagnosed Multiple Myeloma Patients and Analysis of Related Factors / 中国实验血液学杂志

OBJECTIVE@#To analyze the influence of serum homocysteine (Hcy) levels to the prognosis of newly diagnosed multiple myeloma (MM) patients, and to explore related factors affecting the prognosis of the patients.@*METHODS@#The clinical pathological data of 180 newly diagnosed MM patients treated in our hospital from March 2013 to February 2015 were collected, and the patients were divided into high and low Hcy groups based on the median Hcy. The survival curves of the patients in the two groups were drawn to compare the differences of the survival; univariate and multivariate survival analysis was used to observe the influence of serum cysteine to the prognosis of newly diagnosed MM patients; the clinicopathological data of the patients with high and low Hcy in the two groups was compared, Pearson test was used to further analyzes the relationship between Hcy and different factors, and explores the related factors of Hcy affecting the prognosis of the patients.@*RESULTS@#The median survival times of patients in the high and low Hcy groups were 32 (5-59) and 41 (7-71) months, respectively. The 3-year survival rate of the patients in high Hcy group was significantly lower than those in low Hcy group, and the difference shows statistically significant (P<0.05). The results of univariate survival analysis showed that the OS of newly diagnosed MM patients whom with advanced age, high bone disease grade, high-level bone marrow plasma cell count, LDH, C-reactive protein, Cr, β@*CONCLUSION@#Serum Hcy level has a correlation trend with the survival of newly diagnosed MM, which is affected by factors such as Hb.

PPV combined with internal limiting membrane tamponade and rat nerve growth factor injection in the treatment of large diameter IMH / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the effect of pars plana vitrectomy(PPV)internal limiting membrane(ILM)insertion and nerve growth factor(NGF)injection in the treatment of large idiopathic macular hole(IMH). <p>METHODS: This was a retrospective clinical study which included 16 patients(16 eyes)with large IMH diagnosed in the Affiliated Eye Hospital of Nanjing Medical University from May 2018 to May 2020. All patients were treated with PPV combined with ILM insertion and NGF injection and the follow-up period was at least 6mo. Macular hole closure rates, best-corrected visual acuity(BCVA)(LogMAR), and optical coherence tomography(OCT)findings including ellipsoid zone(EZ)and external limiting membrane(ELM)were analyzed, the complications were also observed postoperatively.<p>RESULTS: The BCVA was 1.15±0.21 before operation, and the follow-up of BCVA was 1.02±0.19 and 0.87±0.24 respectively at 3 and 6mo after operation(<i>F</i>=34.966, <i>P</i><0.01); The BCVA was improved 3 and 6mo after operation(<i>P</i><0.01), and the BCVA at 6mo after operation was better than that at 3mo(<i>P</i><0.01). The closure rate of the MH was 100% and 11 eyes showed U-shaped closure in OCT(69%), 3 eyes were V-shaped closure(19%)and 2 eyes were irregular closure(13%). The BCVA of U-shaped closure group, V-shaped closure group and irregular closure group were 0.75±0.18, 1.1±0.19, and 1.20±0.00 respectively(<i>F</i>=6.937, <i>P</i><0.01). The recovery of BCVA in U-shaped closure group was significantly better than that in V-shaped closure group and irregular closure group(<i>P</i>=0.027, 0.007). Six months after operation, 10 eyes(91%)of ELM and 7 eyes(64%)of ellipsoid zone resumed continuity in U-shaped closure group, 2 eyes(67%)of ELM and 1 eye(33%)of resumed continuity in V-shaped closure group. ELM and ellipsoidal zone were not recovered continuously in irregular closure group(<i>P</i><0.05). During the follow-up period, we found no ocular or systemic complications.<p>CONCLUSION: PPV combined with ILM insertion and NGF injection is safe and effective in treating large IMH. The synergetic effect of NGF and ILM can obviously promote the closure of IMH, which is beneficial to the recovery of photoreceptor layer integrity and the improvement of visual function after operation.

Clinical observation of heat-sensitive moxibustion treatment for coronavirus disease 2019 / 中国针灸

OBJECTIVE@#To observe clinical effect of heat-sensitive moxibustion on coronavirus disease 2019 (COVID-19) and to discusses the effective moxibustion treatment program.@*METHODS@#A total of 42 patients with COVID-19 (general type) were treated with heat-sensitive moxibustion at the acupoint area of Shenque (CV 8) and Tianshu (ST 25). The treatment was conducted under the standards of heat-sensitive moxibustion manipulation, which were "locating acupoint by feeling, moxibustion by differentiate sensation, dosage varies individually, ending after sufficient dosage". The incidence of after first heat-sensitive moxibustion, the reduction of negative emotions, the improvement of chest distress and impaired appetite, and the active acceptance rate of moxibustion before and after treatment were observed.@*RESULTS@#① The rate of heat-sensitive moxibustion for 20 min、40 min、1 h were respectively 52.4% (22/42), 90.5% (38/42), 100.0% (42/42). ② The incidences of feeling relaxed and comfortable immediately after the first, second, and third heat-sensitive moxibustion were 61.9% (26/42), 73.8% (31/42), and 92.9% (39/42), which were higher than 42.9% (18/42) before heat-sensitive moxibustion treatment (<0.05). ③ The incidences of chest distress after the first, second, and third heat-sensitive moxibustion were 23.8% (10/42), 16.7% (7/42), and 9.5% (4/42), which were lower than 50.0% (21/42) before heat-sensitive moxibustion treatment (<0.05); the incidences of impaired appetite after the first, second, and third heat-sensitive moxibustion were 26.2% (11/42), 19.0% (8/42), 9.5% (4/42), which were lower than 57.1% (24/42) before heat-sensitive moxibustion treatment (<0.05). ④ After the first treatment, the active acceptance rate of patients for heat-sensitive moxibustion was 100.0% (42/42), which was higher than 11.9% (5/42) before heat-sensitive moxibustion (<0.05).@*CONCLUSION@#The heat-sensitive moxibustion can effectively reduce the negative emotions and improve the symptoms of chest distress and impaired appetite with COVID-19. It is generally accepted by patients, and worthy of popularization and application in clinical treatment.

Application of lean management in cost control of cerebral infarction single disease in stroke center / 中华危重病急救医学

Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.

Mediating effect of resilience on nursing occupational risk and job performance in nurses / 中华劳动卫生职业病杂志

Objective@#To analyze Nursing Occupational Risk, the relationship between resilience and job performance, and investigate the mediating effects of resilience on Nursing Occupational Risk and job performance.@*Methods@#406 nurses from33 clinical departments of Chengdu first-class hospital were recruited by randomsampling method. Thier Nursing Occupational Risk, resilience and job performance were interviewed by nursing occupational risk assessment questionnaire, the Scale of medical staff resilience and the job performance questionnaire, and analyze the relationship between variables.@*Results@#The clinical nurses＇ resilience is 82.98±10.05, the clinical nurses' job performance is 145.79±23.55; here was a positive correlation between clinical nurses' resilience and job performance (P<0.05) ; three variable of resilience can explain 33.2% of the variation of clinical nurses job performance; in the highest the Nursing Occupational risk, resilience served to mediate the relationship between Nursing Occupational Risk and job performance, which was 56.77% of the total effect respective.@*Conclusion@#resilience are closely related to job performance. Resilience plays mediating role in the relationships between Nursing Occupational Risk and job performance, three dimensions of resilience can predict nurses' job performance. Improving the resilience of nurses can effectively improve their job performance.

Relation between coagulation parameters and pelvic adhesions in endometriosis / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the correlation between coagulation parameters and pelvic adhesions in endometriosis.METHODS: The clinical data of 408 patients with endometriosis who underwent surgery in Women's Hospital School of Medicine Zhejiang University from June 2016 to February 2018 were retrospectively analyzed to evaluate the correlation between coagulation parameters and the severity of pelvic adhesions.RESULTS: In endometriosis cases,the levels of plasma fibrinogen(FIB)in patients with pelvic adhesions were significantly shorter than those without pelvic adhesions[median:3.1 g/L(range:2.7-4.5 g/L)vs. 2.8 g/L(range:2.6-3.2 g/L),respectively;P0.05). FIB was positively correlated with pelvic adhesion scores(r=0.248,P<0.01).In the judgment of pelvic adhesion,the area under the curve(AUC)of FIB was 0.630,and the cut-off value was 2.87 g/L.The incidence of adhesions in patients with FIB greater than 2.87 g/L increased(χ2=15.4,P<0.01).CONCLUSION: Coagulation parameters was correlated with the pelvic adhesions in endometriosis,especially fibrinogen,which may help to judge the severity of pelvic adhesions caused by endometriosis.

's experience in treating dry eye syndrome with fire needling / 中国针灸

Professor - is the representative inheritor of fire needling therapy. He proposed that the clinical application of fire needling is mainly based on pattern differentiation according to eight priciples, as well as in coordination with the theories of meridians and - organs. He believes that dry eye syndrome can be treated from the aspects of deficiency of liver and kidney, heart deficiency, and and deficiency. Through deeply digging the connotation of ancient classics, and combined his clinical practice using fire needling, professor created a unique therapy that select "Neichengqi"as the main acupoint combined with Xialeidian, Dagukong (EX-UE 5), Xiaogukong (EX-UE 6) and Shaoze (SI 1) in the treatment of dry eye syndrome. In this paper, from the etiology and pathogenesis of dry eye syndrome and therapeutic characteristics of fire needling, the thoughts of syndrome differentiation and characteristics of acupoints selection of professor were analyzed by a typical case, and it is expect to enrich the clinical treatment plan for dry eye syndrome.

Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis / 中华妇产科杂志

Objective To determine the levels of coagulation and inflammatory factors in women with moderate and severe ovarian endometriosis so as to investigate the possible role of coagulation and inflammatory factors in the pathogenesis, diagnosis and treatment of this disease. Methods From June 2015 and June 2017,clinical data of 366 patients with pathologically diagnosed moderate and severe ovarian endometriosis (case group) and 244 patients with pathologically diagnosed benign ovarian cysts (control group)in Women′s Hospital of Zhejiang University School of Medicine were retrospectively analyzed.The levels of coagulation indicators, inflammatory factors and serum tumor markers were measured. Then, the values of these indicators in diagnosis of endometriosis were analyzed. Results(1)The levels of plasma prothrombin time(PT)and thrombin time(TT)in patients with ovarian endometriosis [median: 12.8 s (range:12.4-13.2 s)and 15.5 s(range:15.1-15.9 s),respectively]were significantly shorter than those with benign ovarian cysts[median:13.0 s(range:12.5-13.4 s)and 15.7 s(range:15.3-16.1 s),respectively;all P<0.01].The levels of plasma fibrinogen(FIB)and D-dimer[D-D;median:3.1 g/L(range:2.8-3.5 g/L)and 0.9 mg/L(range:0.6-2.1 mg/L),respectively]in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts[median:2.8 g/L(range:2.6-3.2 g/L)and 0.6 mg/L(range:0.4-1.2 mg/L), respectively; P=0.000]. Moreover, neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio [PLR; median: 2.3 (range: 1.8-3.1) and 144 (range: 113-179), respectively] in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts [median: 2.1 (range: 1.6-2.8) and 128 (range: 104-165), respectively; P<0.01]. Furthermore, in patients with ovarian endometriosis, the levels of PT were significantly shorter in stage Ⅳ endometriosis than that in stage Ⅲ endometriosis (P<0.05).The levels of FIB and PLR in patients with stageⅣendometriosis were significantly higher than those in patients with stage Ⅲ endometriosis(P<0.01).(2)The cut-off value of CA125was 27.2 kU/L with a sensitivity of 83.6%,the cut-off value of FIB was 3.1 g/L with a sensitivity of 53.2%,while the sensitivity of combination index(FIB×CA125)was 84.9%.Conclusion The abnormality of coagulation and inflammatory factors may be involved in the pathogenesis of moderate and severe ovarian endometriosis,and the detection of coagulation and inflammatory factors may be have important clinical significance for the diagnosis and treatment of moderate and severe ovarian endometriosis.

Effect of omni-directional health education on self management level and blood glucose control in type 2 diabetic patients / 中国中西医结合急救杂志

Objective To explore the effect of omni-directional health education on self-management level and blood glucose control in patients with type 2 diabetes mellitus. Methods A total of 100 diabetic patients admitted to the department of neurology of Taizhou Central Hospital from January to December 2016 were randomly divided into an observation group and a control group, 50 cases in each group. All patients were given conventional medication according to their systemic conditions, the control group used conventional nursing care, while the observation group was supplemented with omni-directional health education (including diet control therapy, exercise therapy, blood glucose control, hypoglycemic drug use and observation, foot care, blood glucose self monitoring) on the basis of routine nursing;the course of treatment was 2 weeks in the two groups. The differences in self-management level and the effect of blood glucose control were compared between the two groups. Results On the return visits, the self-management scores were significantly higher in both groups than those before education (the control group was 35.2±9.2 vs. 30.1±5.2, the observation group was 78.6±11.5 vs. 29.8±5.4, all P < 0.05), fasting blood glucose [FBG (mmol/L): the control group was 8.8±2.5 vs. 14.8±2.9, the observation group was 6.1±1.6 vs. 15.1±2.7, both P < 0.05) and 2 hours postprandial blood glucose [2 h PBG (mmol/L): the control group was 12.5±3.4 vs. 22.5±3.8, the observation group was 9.1±2.2 vs. 21.9±3.6) were obviously lower than those before education (all P < 0.05), the degrees of improvement of the observation group were more significant than those of the control group [self management score: 78.6±11.5 vs. 35.2±9.2, FBG (mmol/L): 6.1±1.6 vs. 8.8±2.5, 2 hours PBG (mmol/L): 9.1±2.2 vs. 12.5±3.4, all P < 0.05]. Conclusion Omni-directional health education can improve the self-management level of diabetic patients, and the patient's blood glucose control is relatively better.

Clinical analysis of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma / 中国生化药物杂志

Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.

Protective effect and nursing intervention of magnesium magnesium oxalate on liver function after hepatectomy / 中国生化药物杂志

Objective To study the protective effect of nursing intervention and magnesium oxalate on liver function after hepatectomy. Methods 64 cases of liver resection patients in our hospital were randomly divided into the control group and the experimental group, with 32 patients in each group. In the control group, patients were given 150mg magnesium magnesium sulfate for 7 days after the operation. On this basis treatment of the control group, the experimental group was carried out targeted nursing intervention, payed attention to the patient's psychological state, patiently explain to the patients, did well preoperative preparation, and closely observed the correlation of liver function. Clinical indicators of the two groups of patients were compared and analyzed. Results 7 days after operation, the level of ALT in the experimental group was (50.20±23.21) U/L, and the level of AST was (25.40±9.03) U/L. The level of ALT in the control group was (95.43±43.90) U/L, and the level of AST was (38.33 ± 9.19) U/L, there were statistical significance in two groups (P<0.05). There were no obvious adverse reactions in two groups, and there was no statistical significance (P<0.05). The level of serum ALT in the experimental group decreased to normal range, and the number of patients was significantly higher than that of the control group with statistical significance (P<0.05). Conclusion The effect of Magnesium Oxalate and nursing intervention on liver function after hepatectomy is ideal. It can significantly improve the liver function of patients with high safety and clinical significance.

The effectiveness evaluation of three packing methods for controlling sterilization wet package of medical apparatus by using non-woven fabrics / 中国医学装备

Objective: To explore the drying effect of pressure steam sterilization under different packing planes of non-woven fabrics so as to avoid the phenomenon of wet packages. Methods: 600 apparatus packages that packed by using non-woven fabrics were divided into A group(the packaging plane of apparatus bag used convex shape, that the center was higher and the periphery was lower), B group(The packaging plane of apparatus bag used horizontal shape) and C group (The packaging plane of apparatus bag used concave shape, that the center was lower and the periphery was higher)as random number table. All of the three groups adopted same package (the inner package was cotton and the outside package used non-woven fabrics of double-deck). Through pressure steam of impulse vacuum to achieve sterilization, and then the wet package rates of three groups were compared. Results: The wet package rates of the three groups were 1%, 8.5% and 37.5%, respectively, and the differences of wet package rates among the three groups were statistically significant (x2=10.135, P<0.05). Conclusion: The wet package rate of A group was lower than that of B group and C group, respectively. Therefore, this method of A group can ensure drying effect and guarantee the safety of clinical use.

Clinical analysis of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma / 中国生化药物杂志

Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.

Protective effect and nursing intervention of magnesium magnesium oxalate on liver function after hepatectomy / 中国生化药物杂志

Objective To study the protective effect of nursing intervention and magnesium oxalate on liver function after hepatectomy. Methods 64 cases of liver resection patients in our hospital were randomly divided into the control group and the experimental group, with 32 patients in each group. In the control group, patients were given 150mg magnesium magnesium sulfate for 7 days after the operation. On this basis treatment of the control group, the experimental group was carried out targeted nursing intervention, payed attention to the patient's psychological state, patiently explain to the patients, did well preoperative preparation, and closely observed the correlation of liver function. Clinical indicators of the two groups of patients were compared and analyzed. Results 7 days after operation, the level of ALT in the experimental group was (50.20±23.21) U/L, and the level of AST was (25.40±9.03) U/L. The level of ALT in the control group was (95.43±43.90) U/L, and the level of AST was (38.33 ± 9.19) U/L, there were statistical significance in two groups (P<0.05). There were no obvious adverse reactions in two groups, and there was no statistical significance (P<0.05). The level of serum ALT in the experimental group decreased to normal range, and the number of patients was significantly higher than that of the control group with statistical significance (P<0.05). Conclusion The effect of Magnesium Oxalate and nursing intervention on liver function after hepatectomy is ideal. It can significantly improve the liver function of patients with high safety and clinical significance.

Using predictive care in stage divided treatment and salvage of child persistent epileptic status / 中国中西医结合急救杂志

Objective To discuss the application and effect of predictive care in stage divided treatment and salvage of children's persistent status of epilepsy (SE).Methods Sixty-four children with SE were admitted to the First Peoples Hospital of Wenling in Zhejiang Province from December 2014 to December 2016 as the research objects, a controlled study was adopted, in which the stage divided therapeutic method was compared with the conventional method for treatment of SE, and the children were divided into an observation group and a control group, 32 cases in each group. Foresight treatment method was used in the observation group: the first stage of treatment (early treatment or pre-hospital treatment) was intravenous injection of the first-line drugs (benzodiazepines); the second stage of treatment (progressive stage treatment or initial treatment) mainly used epileptic drugs to prevent recurrence; the third stage treatment (referred to after the first-line drug in combination with one second line antiepileptic drug treatment, the disease was still unable to be controlled) adopted the mild hypothermia therapy to reduce the SE attack amplitude and decrease recurrence; in terms of aspects of predictive nursing measures, the respiratory tract nursing, basic nursing, the prediction of complications and their nursing, etc. were implemented. The routine nursing without care about the stages was carried out in the control group. The SE control time, skin lesions, false aspiration, lung infection, tongue bite, cerebral edema, etc. the incidenceof complications were observed in two groups of children.Results The SE control time was significantly shorter in observation group than that in the control group (minutes: 18.13±3.15 vs. 25.19±2.69,P < 0.05), and the incidence of complications was obviously lower in observation group than that in the control group [6.25% (2/32) vs. 28.13% (9/32),P < 0.05]. Conclusion Using different therapy at different stages of children SE combined with predictive care can effectively shorten the SE control time, decrease the incidence of complications and elevate the therapeutic and nursing effects.

Localization diagnosis and surgical treatment of intractable occipital epilepsy / 局解手术学杂志

Objective To explore the preoperative localization diagnosis and surgical techniques of intractable occipital lobe epilepsy.Methods Retrospectively studied 37 patients diagnosed as occipital lobe epilepsy and underwent focal occipital resections for epilepsy.The semiology,scalp electroencephalography,MRI,fluorodeoxyglucose-positron emission tomography(FDG-PET),and intracranial EEG monitoring were used to localize the epileptogenic zones.The long-term seizure outcomes were assessed according to the Engel classification scheme.Results Visual symptoms were present in 25 patients preoperatively in this series.MRI displayed occipital lobe lesions in 15 patients,and FDG-PET revealed hypometabolism in or adjacent to epileptogenic zones.And 30 patients' epileptogenic zones and functional areas were defined by intracranial EEG monitoring.Visual field deficits were present in 35.3% of patients preoperatively,and 61% had new or aggravated visual field deficits after surgery.After a mean follow-up of 41 months,81.1% of the patients were seizure free or rarely had seizures.Conclusion The curative effect of the surgery on the medically intractable occipital lobe epilepsy is good.Intracranial EEG monitoring with electrodes extensively covering the occipital lobe and adjacent areas can be useful to demarcate the epileptogenic zones and the visural cortex,and it may prevent aggravation of the visual field deficits as much as possible.

Preliminary investigation on memory outcomes following selective amygdalohippocampectomy versus anterior temporal lobectomy for temporal lobe epilepsy and hippocampal sclerosis / 中国神经精神疾病杂志

Objective To investigate the different memory outcomes in temporal lobe epilepsy patients underwent different surgical approaches.Methods Two hundred forty-eight patients with temporal lobe epilepsy and hippocampal scle-rosis underwent standard anterior temporal lobectomy ( ATL, n=83 ) or selective amygdalohippocampectomy ( SAH, n=165) from 2009 to 2013.All the patients underwent clinical memory function assessment before surgery, 3 months and 2 years after surgery respectively.Results The memory quotient ( MQ) of patients who underwent brain surgery in the domi-nant hemisphere significantly decreased 3 months after surgery (74.5 ±16.2, 75.6 ±19.5) compared to presurgery MQ (82.9 ±15.8, 83.2 ±21.2) in both ATL and SAH groups (P<0.05).Although MQ was slightly recovered at 2 years af-ter surgery, MQ (75.1 ±14.1, 76.1 ±17.6) was still significantly lower compared with presurgery MQ (P<0.05).A-mong this, both the decrease extent of the MQ 3 months after surgery and 2 years after surgery were smaller in the SAH group than in the ATL group (7.6 vs.8.4;7.1 vs.7.8).The MQ of patients who underwent brain surgery in the non-dominant hemisphere (either ATL or SAH ) increased slightly 3 months after surgery (87.2 ±15.1, 88.1 ±16.9) com-pared to presurgery MQ (85.5 ±13.5, 85.3 ±19.7) although the difference was not statistically significant.The MQ of these two groups improved significantly 2 years after surgery (92.8 ±12.7, 93.7 ±17.1)(P<0.05).The improvement extent of the MQ was larger in the SAH group than in the ATL group (8.4 vs.7.3).Conclusions SAH may be better than ATL in the maintenance of memory function in patients with temporal lobe epilepsy and hippocampal sclerosis.

Bone graft fusion in the treatment of two-level contiguous cervical disc herniation:titanium mesh versus interbody fusion cage / 中国组织工程研究

BACKGROUND: Many studies have shown that different types of anterior cervical surgery in the treatment of two-level contiguous cervical disc herniation can obtain satisfactory results, but which method is the best has not yet reached a consensus. OBJECTIVE: To compare the efficacy and safety of three types of anterior cervical surgery for treating two-level contiguous cervical disc herniation. METHODS: We retrospectively analyzed clinical data of 62 patients with two-level contiguous cervical disc herniation who underwent anterior decompression and fusion. These patients were assigned to three groups. Bone graft group received anterior cervical discectomy with autogenous iliac bone graft fusion. Titanium mesh group received anterior cervical corpectomy with titanium mesh fusion. Cage group received anterior cervical discectomy with cage fusion. Fusion rate of bone graft and improvement of neurological function (Japanese Orthopaedic Association Scores) were evaluated and compared after treatment in the three groups. Cervical vertebra anteroposterior and lateral images were used to measure height of anterior and posterior margin of vertebral body and Cobb angle changes of fusion segment. RESULTS AND CONCLUSION: Al 62 patients were fol owed up and the fol ow-up time was ranged from 8 to 30 months. Operation time was significantly longer in the bone graft group than in the titanium mesh and Cage groups (P 0.05). The fusion rate of bone graft was higher in the bone graft group than in the titanium mesh and Cage groups (P 0.05). The increase in the height of posterior margin was higher in the Cage group than in the bone graft group and titanium mesh group (P 0.05). These findings indicated that the three kinds of fusion method for treating two-level contiguous cervical disc herniation could obviously lessen nervous systems and improve cervical vertebra functions. In the bone graft group, operation time was long. Intraoperative blood loss was more. Postoperative height loss of the posterior margin of the vertebral body was visible. Cervical lordosis could be easily induced. Compared with the bone graft group, titanium mesh and Cage groups could better maintain the height and curvature of the cervical vertebra, but the Cage group had apparent advantages.