Based on the theory of "Qi Pulse Constant Communication", the treatment of diabetic peripheral neuropathy by invigorating qi and activating blood was discussed / 国际中医中药杂志

Diabetic peripheral neuropathy (DPN) is the common chronic complication of diabetes, which can lead to foot ulcers, gangrene, and amputation in severe cases, seriously affecting their quality of life. DPN belongs to the category of "arthralgia", "hemorrhoids" and other categories of TCM, and the main pathogenesis is the deficiency of qi and blood, yin and yang, and the obstruction of the meridians by phlegm and stasis. Clinically, DPN is more common with qi deficiency and blood stasis syndrome. Based on the theory of "qi meridian constant communication" in the Huang Di Nei Jing, this article proposed that for patients with DPN with qi deficiency and blood stasis syndrome, the treatment should be based on the principle of "invigorating qi and activating blood circulation, dissolving stasis and arthralgia", so that the patients' qi meridian can be accessible, delay the disease progression, and provide reference for the TCM treatment of DPN.

pH-Responsive polymer boosts cytosolic siRNA release for retinal neovascularization therapy

Small interfering RNA (siRNA) has a promising future in the treatment of ocular diseases due to its high efficiency, specificity, and low toxicity in inhibiting the expression of target genes and proteins. However, due to the unique anatomical structure of the eye and various barriers, delivering nucleic acids to the retina remains a significant challenge. In this study, we rationally design PACD, an A-B-C type non-viral vector copolymer composed of a hydrophilic PEG block (A), a siRNA binding block (B) and a pH-responsive block (C). PACDs can self-assemble into nanosized polymeric micelles that compact siRNAs into polyplexes through simple mixing. By evaluating its pH-responsive activity, gene silencing efficiency in retinal cells, intraocular distribution, and anti-angiogenesis therapy in a mouse model of hypoxia-induced angiogenesis, we demonstrate the efficiency and safety of PACD in delivering siRNA in the retina. We are surprised to discover that, the PACD/siRNA polyplexes exhibit remarkable intracellular endosomal escape efficiency, excellent gene silencing, and inhibit retinal angiogenesis. Our study provides design guidance for developing efficient nonviral ocular nucleic acid delivery systems.

Practice and reflection of day surgery in a tertiary hospital in Tianjin / 现代医院

Objective To analyze the implementation of day surgery in a public hospital in Tianjin,and to provide refer-ence for the quantity and quality of day surgery.Methods The implementation of day surgery in a public hospital in Tianjin from 2020 to 2022 was analyzed.Results From 2020-2022,the main types of daytime operations were secondary(43 kinds)and ter-tiary operations(28 kinds).In terms of the implementation of professional disciplines,anorectal surgery,urology surgery and orthopedics carried out the largest number of operations,among which anorectal surgery accounted for 70.76％(2 285/3 229).Conclusion It is necessary to further improve the development of professional disciplines,the management system of day surger-y,and the guarantee of medical services,strengthen the construction of weak links in the management path of day surgery and im-prove the coverage and accessibility of day service.

A clinical study on the treatment of primary trigeminal neuralgia with a new type of laser localization assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery / 中国医师杂志

Objective:To explore the clinical efficacy and safety analysis of a novel laser localization technology assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery for the treatment of primary trigeminal neuralgia.Methods:A retrospective selection was conducted on 63 patients with primary trigeminal neuralgia who underwent percutaneous puncture of the trigeminal nerve microsphere capsule compression surgery at the First Hospital of Hunan University of Chinese Medicine from January 2020 to December 2021. According to different surgical methods, they were divided into a new laser localization assisted puncture group (observation group) of 32 cases and a traditional barehanded localization puncture group (control group) of 31 cases. An analysis was conducted on the surgical time, puncture time, puncture frequency, intraoperative exposure to radiation, number of cases of poor balloon formation, and clinical efficacy within 6 months after surgery for two groups of patients. The prognosis of the patients was followed up at 6 months after surgery.Results:The surgical time, puncture time, puncture frequency, and intraoperative exposure of the observation group were all less than those of the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference ( P>0.05) in the number of cases of poor balloon angioplasty between the observation group and the control group, as well as the pain score grading of the Barlow Neurological Institute (BNI) on the first day after surgery. Within 6 months after surgery, there was no statistically significant difference in the incidence of facial numbness, diplopia, masseter weakness, perilabial herpes, and recurrent pain between the two groups of patients (all P>0.05). Conclusions:Laser positioning technology can assist in precise puncture of the foramen ovale and accurate placement of balloons based on surgical experience, which helps to improve surgical safety, reduce postoperative complications and intraoperative radiation dose, and achieve satisfactory short-term follow-up results.

The clinical effect of the long head of biceps tendon insertion reconstruction combined with pulley repair in the treatment of pulley system injuries / 中华骨科杂志

Objective:To investigate the clinical effect of long head of biceps tendon (LHBT) insertion reconstruction combined with pulley repair for pulley system injuries.Methods:A total of 46 patients (combined treatment group) with pulley system injury treated with LHBT insertion reconstruction combined with pulley repair in the Sports Medicine Department, Affiliated Xinhua Hospital of Dalian University from January to December 2020 were retrospectively analyzed, including 16 males and 30 females, aged 51.3±5.7 years (range, 45-72 years). 46 patients who underwent simple LHBT insertion reconstruction during the same period were selected as the control group (simple reconstruction group), including 14 males and 32 females, aged 50.6±6.7 years (range, 46-70 years). Visual analogue scale (VAS), Constant-Murley score, American Shoulder and Elbow Surgeon (ASES) score and long head of biceps tendon (LHB) score were compared preoperatively and at 1, 3, 6, 12 and 24 months postoperatively.Results:All patients were followed up for 26.2±1.5 months (range, 24-27 months). The VAS scores of the combined treatment group at 1, 3, and 6 months postoperatively were 3.4±1.3, 2.0±1.1, and 1.7±0.5, respectively, which were significantly lower than those of the simple reconstruction group 5.8±1.3, 3.5±1.1, and 2.6±0.5 ( P<0.05), while there was no significant difference between the two groups at 12 and 24 months postoperatively ( P>0.05). The Constant-Murley scores of the combined treatment group at 1, 3, and 6 months postoperatively were 31.3±4.7, 72.8±4.6, and 89.1±5.4, respectively, which were statistically greater than those of the simple reconstruction group (21.5±6.8, 52.8±5.2, and 80.1±6.2), and the differences were statistically significant ( P<0.05), while there was no statistically significant difference between the two groups at 12 and 24 months postoperatively ( P>0.05). The ASES scores of the combined treatment group at 1 and 3 months postoperatively were 56.2±6.9 and 82.7±8.2, which were statistically greater than those in the simple reconstruction group (40.2±5.6 and 62.9±8.0), while there was no statistically significant difference between the two groups at 6, 12, and 24 months postoperatively ( P>0.05). The LHB scores of the combined treatment group at 6 and 12 months postoperatively were 70.1±5.4 and 86.1±4.6, which were statistically greater than those of the simple reconstruction group (60.2±4.2 and 70.2±5.8), with statistically significant differences ( P<0.05), while there was no statistically significant difference between the two groups at 24 months postoperatively ( P>0.05). Conclusion:Arthroscopic LHBT insertion reconstruction combined with pulley system repair can relieve early postoperative shoulder pain and improve early function. It is an effective method for the treatment of pulley system injury.

Practice and exploration of multi-station assessment mode for residents in a large hospital under the new situation / 现代医院

The standardized training of resident doctors has entered a new stage of quality construction.The multi-station assessment in clinical context takes clinical problems as the core and residents as the main body,and uses the way of integrating practice and clinical thinking training to help residents build the comprehensive ability to solve clinical practical problems.This paper reviews and summarizes the practice of multi-station assessment mode in a tertiary hospital in Tianjin in recent three years from the aspects of assessment scheme,examination station setting,examination content,requirements and characteristics of ex-amination questions.Problem-oriented,find out the problems existing in the operation process and put forward solutions,so as to provide a reference for further improving the assessment and training system,promoting the training management of residential training bases and improving the training quality.

Shoulder arthroscopic balance point compaction with cross suture-bridge technique for treatment of avulsion fracture of the greater tuberosity of the humerus / 中华创伤杂志

Objective:To investigate the efficacy of shoulder arthroscopic balance point compaction with cross suture-bridge technique inr the treatment of avulsion fracture of the greater tuberosity of the humerus.Methods:A retrospective case series study was conducted on 14 patients with avulsion fracture of the greater tuberosity of the humerus treated in Affiliated Xinhua Hospital of Dalian University from March 2021 to March 2022, including 8 males and 6 females; aged 30-58 years [(40.2±10.5)years]. Among them, 5 patients had fracture in the left shoulder and 9 in the right shoulder. The fracture was classified as the avulsion type according to Mutch classification. All the patients were treated with shoulder arthroscopic balance point compaction with cross suture-bridge technique. The anteroposterior X-ray of the shoulder joint was taken at 1 week, 3 months, and 6 months after surgery to evaluate fracture reduction and fixation. The operative time and intraoperative blood loss were recorded. Fracture healing was evaluated by shoulder MRI at 6 months after surgery. The visual analog score (VAS), Constant shoulder joint score, American Shoulder and Elbow Surgeons (ASES) score, and shoulder range of motion (active abduction angle, active lateral external rotation angle, and active lateral internal rotation) preoperatively, at 3, 6 months after surgery and at the last follow-up were compared. The postoperative complications were observed.Results:All the patients were followed up for 12-15 months [(12.5±0.8)months]. The operative time and intraoperative blood loss were (67.0±10.5)minutes and (20.0±3.8)ml. The anteroposterior X-ray of the shoulder joint showed good reduction and fixation at 1 week, 3 months and 6 months after surgery. MRI T1 image at 6 months after surgery showed locally evenly distributed high signal, suggesting that the fracture was healed well. The values of VAS were (3.2±0.4)points, (2.5±0.5)points, and (0.7±0.3)points at 3, 6 months after surgery and at the last follow-up, which were lower than (7.2±0.6)points preoperatively; the values of Constant joint shoulder score were (53.2±5.3)points, (81.1±4.4)points, and (92.8±5.3)points, which were higher than (42.3±7.6)points preoperatively; the values of ASES score were (55.6±3.6)points, (77.1±3.2)points, and (90.8±3.5)points, which were higher than (45.8±4.2)points preoperatively; the active abduction angles were (60.5±2.5)°, (107.8±6.6)°, and (168.5±3.5)°, which were higher than (18.3±3.3)°preoperatively; the active lateral external rotation angles were (25.8±2.5)°, (30.8±2.2)°, and (63.8±2.8)°, which were higher than (15.6±3.2)°preoperatively ( P<0.05 or 0.01). The level of active internal rotation was L 5, L 1, and T 10, which was better than S 3 before surgery. The VAS, Constant shoulder joint score, ASES score, active abduction and active external rotation were significantly improved at the last follow-up compared with those at 3, 6 months after surgery (all P<0.05), with markedly improved level of active internal rotation. No major complications such as infection, instability of the shoulder joint or acromial impingement were found after surgery. Conclusion:Shoulder arthroscopic balance point compaction with cross suture-bridge technique for the treatment of avulsion fracture of the greater tuberosity of the humerus has advantages of decreased intraoperative blood loss, good reduction and healing, shoulder pain relief, early restoration of shoulder function and mobility, and few complications.

Construction of a classification model for image subtypes based on the radiomics features of patients with dermatomyositis/polymyositis-related interstitial lung disease for machine learning / 中华风湿病学杂志

Objective:To investigate the feasibility of classifying imaging patterns of dermatomyositis/polymyositis-related interstitial lung disease (DM/PM-ILD) into subtypes based on chest CT radiomics features and a model was constructed by machine learning algorithms.Methods:From November 2011 to November 2020, 107 patients diagnosed with PM/DM-ILD at the First Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. A total of 315 cases with chest CT were collected. Doctors pre-classified image patterns, including 105 cases with non-specific interstitial pneumonia (NSIP), 90 cases with organizing pneumonia (OP), and 66 cases with non-specific interstitial pneumonia combined with organizing pneumonia (NSIP+OP), 35 cases with common interstitial pneumonia (UIP), and 19 cases with diffuse alveolar damage (DAD), ANOVA was used to test the difference of baseline clinical information among the imaging classification groups. All images were divided into the training set and the est set by stratified random sampling at a ratio of 4∶1. In each CT scan, 3D slicer was used to segment each lung lobe, and then reconstructed into 3 mm 3 of voxels, and Pyradiomics library was used to extract the radiomic features of the whole lung and each lobe. The multi-classification goal was achieved by constructing random forest base classifiers for each of the five groups and then voting as the final model. In the process of constructing the base classifier, firstly, the balance between sample groups was achieved by SMOTETomek comprehensive sampling, and the optimal feature set was selected by independent sample t test and L1 regularized least absolute shrinkage and selection operator (LASSO) regression. In this study, the Radiomics model was constructed based on chest CT radiomics features, and the Radiomics + model was constructed by introducing gender and age information. The base classifier and the integration model use the mean accuracy and the area under the receiver operator characteristics analysis curve (AUC) to evaluate the performance, respectively. Results:There was a statistically significant difference ( P<0.05) between the ages of the NSIP, OP, NSIP+OP, UIP, and DAD groups [(57±13),(53±8),(54±10),(44±11), and (46±8)years old, respectively], F=11.82, P<0.001. In the Radiomics model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.87, 0.91, 0.91, 0.96, and 0.99, respectively, and the AUC of the test set were 0.81, 0.82, 0.79, 0.93, 0.89. In the final Radiomics + model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.89, 0.91, 0.92, 0.97, and 0.99, respectively, and the AUCs of the test set were 0.84, 0.82, 0.78, 0.94, 0.90. Conclusion:Based on chest CT radiomics features and key clinical features (sex, age), the Radiomics + model constructed by machine learning has good classification performance for the imaging patterns of PM/DM-LD.

Analysis of pathogenic bacteria and influencing factors of death in patients with severe neurological pulmonary infection / 中国医师杂志

Objective:To investigate the distribution of respiratory pathogens and risk factors of death in patients with pulmonary infection in neurosurgical intensive care unit (NICU).Methods:A total of 87 patients with pulmonary infection in the NICU of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2018 to December 2019 were collected, and the pathogens of their respiratory tract were analyzed to understand the types and distribution of bacteria in the lung infection. Univariate statistical analysis was used to analyze the relationship between the patient′s clinical outcome with age, diabetes, hypertension, renal insufficiency, hypoproteinemia, anemia, chronic respiratory disease, surgery, tracheotomy, and bacterial multi-resistance. Binary logistic regression analysis was used to analyze the influencing factors of death in NICU patients with pulmonary infection.Results:A total of 112 pathogenic bacteria were isolated in this research group, including 83 Gram-negative bacteria (74.11%), 22 Gram-positive bacteria (19.64%), and 7 Fungi (5.25%). Imipenem was highly sensitive to Gram-negative bacteria, vancomycin was highly sensitive to Gram-positive bacteria, and other drugs were highly resistant. 41 patients died (47.13%). Age≥60 ( OR=3.501, 95% CI: 1.152-10.638), renal insufficiency ( OR=3.872, 95% CI: 1.336-11.224), tracheotomy ( OR=0.317, 95% CI: 0.114-0.882), bacteria multi-drug resistance ( OR=3.480, 95% CI: 1.162-10.422) were independent risk factors for death in NICU patients with pulmonary infection. Conclusions:Patients with severe neurological diseases are in critical condition, and there are many patients with pulmonary infection, with poor prognosis and high mortality. Gram-negative bacteria are the most common respiratory pathogens. Carbapenems account for the highest proportion of antibiotics in clinic. Advanced age, renal insufficiency and bacterial multidrug resistance increase the mortality of patients, while early tracheotomy can reduce the mortality of patients.

Effects of Tangtong formula on the expression of PI3K, Akt and mTOR in sciatic nerve of diabetic peripheral neuropathy rats / 国际中医中药杂志

Objective:To observe the effect of Tangtong formula on the expression of autophagy pathway proteins PI3K, Akt and mTOR in sciatic nerve of DPN rats, and to explore its mechanism. Methods:There were 60 male SD rats, 15 of which were randomly selected as the normal group, and the other rats were used to establish DPN model with STZ + ischemia-reperfusion method. Then they were divided into model group, Tangtong formula low-dose group and Tangtong formula high-dose group, with 15 rats in each group with random number table method. 36.67 g/kg Tangtong formula was administered by gavage in the high-dose group and 18.33 g/kg Tangtong formula was administered by gavage in the low-dose group, once a day. After 8 weeks of continuous gavage, the conduction velocity of sciatic nerve was detected. The mRNA and protein expression levels of PI3K, Akt and mTOR were detected by PCR and Western blot. The structure of sciatic nerve fibers was observed by HE staining. Results:Compared with the model group, the motor nerve conduction velocity, sensory nerve conduction velocity, muscle compound action potential and sensory nerve action potential in the low-dose Tangtong formula group and high-dose Tangtong formula group were increased ( P<0.05). The expression of PI3K mRNA(6.05±0.18, 3.36±0.29 vs. 11.57±1.93), Akt mRNA(1.26±0.13, 0.64±0.04 vs. 1.86±0.06), mTOR mRNA(1.82±0.11, 0.92±0.06 vs. 2.68±0.18) of sciatic nerve in rats of the low-dose and high-dose group were increased ( P<0.05). The expression of PI3K(0.40±0.00, 0.19±0.02 vs. 0.61±0.03), Akt(0.64±0.02, 0.45±0.01 vs. 0.83±0.02), mTOR(0.17±0.01, 0.09±0.00 vs. 0.34±0.01)of sciatic nerve in rats of the low-dose and high-dose group were increased ( P<0.05). The model group's nerve fibers were loose and swollen, myelin sheath became thin, and the axis Atresia, the neuromorphology of the low-dose and high-dose group tended to be normal, and the morphology of myelin sheath and axon were better. Conclusions:Tangtong formula could improve the conduction velocity and potential amplitude of sciatic nerve in DPN rats, reduce nerve injury and demyelinating changes, improve axon morphology and protect nerve fiber structure. Its mechanism might be related to activating PI3K/Akt/mTOR signal pathway and inhibiting excessive autophagy.

The application of two flap dissection methods in the standard large decompressive craniectomy / 中国医师杂志

Objective:To compare the application effect of electrotome flap separation and neuro dissector in standard large decompressive craniectomy (SLDC).Methods:From January 2020 to December 2020, 40 patients with severe craniocerebral injury who met the standard and planned to undergo SLDC were randomly divided into two groups: 20 patients in the electrotome separation group and 20 patients in the nerve dissector group. The time of flap seperation, the degree of edema and atrophy of temporal muscle on the operation side were compared between the two groups.Results:There was no significant difference in the time of flap separation between the two groups [(20.91±12.33)min vs (29.92±12.69)min, t=1.799, P>0.05]. The patients in the two groups had different degrees of temporal muscle edema 48 hours after operation. The degree of temporal muscle edema in the electrotome separation group was more serious than that in the nerve dissector group [(18.82±5.23)cm 3 vs (10.71±3.69)cm 3,t=7.314, P<0.05]. The degree of temporal muscle atrophy in the electrotome separation group was higher than that in the nerve dissector group [(8.26±2.38)cm 3 vs (6.72±2.13)cm 3,t=2.314, P<0.05]. Conclusions:In SLDC surgery, there was no significant difference in flap separation time between electrotome separation flap method and neuro dissector flap separation method, but the latter had less damage to temporal muscle and less atrophy of temporal muscle after operation.

Clinical characteristics of patients with listeriosis / 中南大学学报(医学版)

OBJECTIVES@#To investigate the clinical characteristics of patients with listeriosis and to provide a basis for diagnosis, treatment, prevention and control of hospital infection.@*METHODS@#A total of 10 inpatients, who suffered from the listeriosis in Xiangya Hospital, Central South University from January 2013 to June 2019, were retrospectively collected for this study. The characteristics of the patients' age, gander, basic information, case type, clinical manifestations, first consultation department, days of diagnosis, infection indicator, specimen type, results of drug sensitivity, treatment plan, hospital infection or not, outcome, follow-up data were analyzed.@*RESULTS@#Two cases were pregnant women and other were non-pregnant adults among 10 patients with listeriosis. Among them, there were 3 cases with hospital acquired infection. The age of patient onset was 27-71 years old, and the time from onset to diagnosis was 5-36 days. Five cases had fever, and other 5 cases had not fever. There were headache, fatigue, local pain, and other specialized symptoms in the 10 patients.The white blood cell count,the neutrophil ratio, the inflammatory index C-reactive protein, the procalcitonin were all increased, and the erythrocyte sedimentation was accelerated in the 10 patients.All the patients were sensitive to ampicillin, penicillin G, meropenem, and compound sinomine.@*CONCLUSIONS@#Listeriosis often affects the patients with low immunity, which often leads to misdiagnosis or missed diagnosis in clinic.So early prevention, early diagnosis, and early treatment can reduce mortality; it is important for departments of nosocomial infection management to manage patients' diet for avoiding outbreaks of listeriosis in hospital.

LG-ESSs and HG-ESSs: underlying molecular alterations and potential therapeutic strategies / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Endometrial stromal tumors (ESTs) include endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). Since these are rare tumor types, there is an unmet clinical need for the systematic therapy of advanced LG-ESS or HG-ESS. Cytogenetic and molecular advances in ESTs have shown that multiple recurrent gene fusions are present in a large proportion of LG-ESSs, and HG-ESSs are identified by the tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein epsilon (

Research progress of T-2 toxin metabolic kinetics / 中华地方病学杂志

As the main pollutant of food crops, T-2 toxin has toxic effects on human and animal digestive system, nervous system, reproductive development and so on. In Kashin-Beck disease related areas in China, the etiological substance of Kashin-Beck disease is the abnormal accumulation of T-2 toxin in the grain produced in the endemic area. The prevention and treatment of Kashin-Beck disease has achieved remarkable results through the comprehensive prevention and control measures, such as changing the production and life style, grain exchange, etc., but there are still pathogenic factors in the external environment of the disease area. In this paper, the metabolic kinetics of T-2 toxin is reviewed, and the physicochemical properties, distribution in the body, metabolic kinetics, biotransformation and damage of T-2 toxin and its metabolites to various organs are described, so as to provide new thinking for the study on the effects of T-2 toxin on various organs of the body.

Effects of HT-2 toxin on expressions of SIRT1, autophagy and apoptosis pathway related proteins in chondrocytes / 中华地方病学杂志

Objective:To explore the effects of HT-2 toxin on expressions of silent information regulator of transcription 1 (SIRT1) and autophagy and apoptosis pathway related proteins in cultured chondrocytes in vitro. Methods:The third-generation chondrocytes of SD neonatal rats aged 1 to 2 days were cultured in vitro and identified by toluidine blue staining and type Ⅱ collagen immunofluorescence staining. CCK-8 method was used to detect the proliferation of chondrocytes. According to the cell survival rate, 2, 4 and 8 ng/ml HT-2 toxin were selected for subsequent experiments, and the exposure time was 48 h. At the same time, a negative control group and a solvent (absolute ethanol) control group were set up. Western blotting was used to detect the expressions of SIRT1 and autophagy and apoptosis pathway related proteins [microtubule-associated protein 1 light chain 3 (LC3)-Ⅱ, LC3-Ⅰ, p62, Beclin1, Caspase-3, B-cell lymphoma-2 (Bcl-2) and Bcl-2-Associated X protein (Bax)] in each group. Results:After staining, the cells were identified as chondrocytes with high purity. The expression levels of SIRT1 protein in 2, 4, 8 ng/ml HT-2 toxin groups (0.69 ± 0.18, 0.46 ± 0.13, 0.35 ± 0.19) were significantly lower than that in negative control group (1.00 ± 0.39, P < 0.05). In 2, 4 and 8 ng/ml HT-2 toxin groups, the ratios of autophagy pathway related proteins LC3-Ⅱ and LC3-Ⅰ expressions (LC3-Ⅱ/LC3-Ⅰ, 1.47 ± 0.15, 1.37 ± 0.13, 1.81 ± 0.34) were higher than that in negative control group (1.00 ± 0.21, P < 0.05), and the expression levels of p62 protein in 4, 8 ng/ml HT-2 toxin groups (0.70 ± 0.04, 0.57 ± 0.01) were lower than that in negative control group (1.00 ± 0.15, P < 0.05). In 2, 4, 8 ng/ml HT-2 toxin groups, the expression levels of apoptosis pathway related protein Bcl-2 (0.61 ± 0.06, 0.54 ± 0.16, 0.47 ± 0.06) were significantly lower than that in negative control group (1.00 ± 0.14, P < 0.05), and the ratio of Bax to Bcl-2 protein expressions in 8 ng/ml HT-2 toxin group (Bax/Bcl-2, 3.27 ± 0.18) was higher than that in negative control group (1.00 ± 0.27, P < 0.05). The expression level of SIRT1 protein was significantly negatively correlated with the expression level of autophagy pathway related protein LC3-Ⅱ ( r = - 0.819, P < 0.01), and was significantly positively correlated with the expression level of p62 protein( r = 0.772, P < 0.01), but not with the expression level of Beclin1 protein ( r = 0.399 , P > 0.05); there was no correlation between SIRT1 protein expression and apoptosis pathway related protein Caspase-3 and Bax expressions ( r = - 0.297、- 0.284, P > 0.05), but there was a significant positive correlation with Bcl-2 protein expression ( r = 0.755, P < 0.01). Conclusion:HT-2 toxin may increase the expression of autophagy pathway related protein LC3-Ⅱ/LC3-Ⅰ, decrease the expression of p62 protein, and increase the apoptosis pathway related protein Bax/Bcl-2 by inhibiting the expression of SIRT1 protein in chondrocytes, resulting in abnormal autophagy and apoptosis, and finally leads to the injury of chondrocytes.

Comparative study of glucosamine sulfate and chondroitin sulfate in the treatment of adult Kashin-Beck disease / 中华地方病学杂志

Objective:To observe and compare the efficacy and safety of glucosamine sulfate (GS) and chondroitin sulfate (CS) in the treatment of adult Kashin-Beck disease (KBD), so as to provide effective medical evidence for the standardized treatment of adult KBD.Methods:A clinical randomized controlled trial was conducted in Fuyu County and Shangzhi City, KBD historical seriously ill areas in Heilongjiang Province. A total of 247 patients were selected according to the standard of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010). According to gender, age and KBD condition, they were randomly divided into GS and CS groups, 124 and 123 respectively. Follow up once a month to investigate the medication and clinical symptoms of patients, and distribute drugs for the next stage. Fasting blood and urine samples were collected before, during and at the end of treatment (0, 90 and 180 d). Serum interleukin (IL)-1β content and urine pyridine (PYD) level were measured by enzyme-linked immunosorbent assay (ELISA). The visual analogue scale (VAS) score, affected joints, self-evaluation of curative effect and side effects were evaluated through the questionnaire, joint dysfunction and drug efficacy were evaluated according to the criteria of "Evaluation of Therapeutic Effect of Kashin-Beck Disease" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: at 180 d of treatment, serum IL-1β contents and urinary PYD levels in GS and CS groups were lower than those at 0 d of treatment ( Z = - 2.461, - 2.160, - 5.075, - 5.471, P < 0.05). VAS score: at 90 and 180 d of treatment, the scores of knee pain, stiffness and function in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05); and at 180 d of treatment, the scores of knee stiffness and function in GS group were lower than those in CS group ( P < 0.05). Evaluation of affected joints: at 90 and 180 d of treatment, the scores of joint pain, swelling and stiffness in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05). Self-evaluation of curative effect: at 180 d of treatment, the self-evaluation of curative of CS group were better than that at 90 d of treatment (χ 2 = 9.376, P < 0.05). Evaluation of side effects: at 90 and 180 d of treatment, the side effects in GS and CS groups were mainly gastrointestinal symptoms. Joint dysfunction score: at 90 d of treatment, the sum of effective rate and markedly effective rate in GS group was higher than that in CS group (χ 2 = 4.042, P < 0.05), but there was no significant difference between the two groups at 180 d of treatment (χ 2 = 0.869, P > 0.05). Conclusion:GS and CS have certain therapeutic effects on adult KBD, which can improve symptoms and reduce serum IL-1β content and urinary PYD level, but GS takes effects quickly, and its effect on improving joint stiffness and function are better than CS.

A comparative study of the efficacy of glucosamine sulfate and diacerein in the treatment of adult Kashin-Beck disease / 中华地方病学杂志

Objective:To observe and compare the therapeutic effects of glucosamine sulfate (GS) and diacerein (DCN) on adult Kashin-Beck disease (KBD).Methods:A clinical randomized controlled trial was conducted in the historical severe KBD areas Fanrong Township, Fulu Town, Long'anqiao Town, Lianghe Town, Shaowen Township of Heilongjiang Province, and 240 patients were selected according to the criteria of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), then divided into GS and DCN groups (gender, age, and KBD condition balanced) via the random number table method, with 120 patients in each group. Followed up once a month to investigate the patient's medication and clinical symptoms, and distributed drugs for the next stage. Fasting blood samples and urine samples were collected before, during, and at the end of treatment (0, 90, and 180 days). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum interleukin (IL)-1β level and urine pyridinol (PYD) level. Visual analog scale (VAS) scores, evaluation of affected joints, self-evaluated efficacy, and evaluation of adverse reactions were carried out through questionnaires. Joint dysfunction scores and medications efficacy determination were performed according to the "Judgment of Kaschin-Beck Disease Treatment Effect" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: after 180 days of treatment, serum IL-1β levels, urine PYD levels in GS group and urine PYD levels in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.332, - 5.420, - 5.204, P < 0.05). VAS scores: after 90 days of treatment, the pain, stiffness scores of patients in GS group and the pain, stiffness, and function scores in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.612, - 2.359, - 3.637, - 2.881, - 2.238, P < 0.05); after 180 days of treatment, the pain, stiffness and function scores of patients in GS and DCN groups were significantly lower than those of the same group at 0 day of treatment ( Z = - 6.738, - 9.530, - 7.781, - 5.428, - 3.761, - 3.587, P < 0.01). Evaluation of affected joints: after 90 and 180 days of treatment, except for pain of weather changes in DCN group, the scores of symptomatic joints in the two groups were lower than those at 0 day of treatment ( P < 0.05). Efficacy self-evaluation: after 180 days of treatment, the self-evaluated efficacy ratio of DCN group was higher than that of GS group and the same group after 90 days of treatment (χ 2 = 4.165, 4.022, P < 0.05). Evaluation of adverse reactions: after 90 and 180 days of treatment, the main adverse reactions of patients in GS and DCN groups were gastrointestinal symptoms. Joint dysfunction scores: after 90 days of treatment, the sum of the effective rate and the markedly effective rate of GS group was higher than that of DCN group (χ 2 = 4.993 , P < 0.05); while after the 180 days of treatment, there was no significant difference between the two groups (χ 2 = 0.417 , P > 0.05). Conclusions:Both GS and DCN have a certain therapeutic effect on adult KBD and can improve clinical symptoms. The GS takes effect quickly, and long-term use can protect cartilage from inflammatory factors to a certain extent.

Effects of Dexmedetomidine on Regional Cerebral Oxygen Saturation and Cerebral Function in Patients underwent Intracranial Aneurysm Embolization / 中国药房

OBJECTIVE：To investigate the effects of dexmedetomidine on regional cerebral oxygen saturation and cerebral function in patients undergoing intracranial aneurysm embolization. METHODS ：Totally 44 patients undergoing intracranial aneurysm embolization in the First Affiliated Hospital of Hunan University of TCM during Jun. 2017-Aug. 2019 were collected and randomly divided into group D （22 cases）and group C （22 cases）. Ten minutes before anesthesia induction ，group D was given intravenous injection of Dexmedetomidine hydrochloride injection 1 μg/kg；group C was given buffered normal saline 20 μL. Both groups were induced with Propofol emulsion injection+Midazolam injection+Fentanyl citrate injection+Cisatracurium besylate for injection. During the operation ，group D was given Dexmedetomidine hydrochloride injection 0.5 μg（/ kg·h）+Fentanyl citrate injection+Benzsulfosum atracurium for injection+Propofol emulsion injection to maintain anesthesia ；group C was continuously pumped with buffered normal saline 0.5 μg（/ kg·h）+Fentanyl citrate injection + Benzsulfosum aratracurium for injection Propofol emulsion injection to maintain anesthesia. Before anesthesia induction （T0）， immediately after anesthesia。induction （T1）， 1 min after tracheal intubation （T2）， immediately after operation finished （T3），immediately afte extubation（T4），the mean arterial pressure（MAP），heart rate 中国药房 2021年第32卷第7期 China Pharmacy 2021Vol. 32 No. 7 ·865· （HR），regional cerebral oxygen satur ation（rSO2）were observed in 2 groups. The levels of neuron specific enolase （NSE）and S100 β protein in serum were measured at T1，T3，6 h after operation （T6）. The recovery time ，intraoperative blood loss ， nitroglycerin amount and the occurrence of ADR were recorded. RESULTS ：MAP and HR of group D at T 2-T4 were significantly lower than those at T 0；MAP and HR of group C at T 2-T4 were significantly higher than those at T 0；the group D were significantly lower than the group C at the same period （P＜0.05）；there was no statistical significance in rSO 2 between 2 groups at T 0-T4（P＞ 0.05）. The levels of serum NSE and S 100β protein in 2 groups at T 3 were significantly higher than at T 1；those in 2 groups at T 6 were significantly lower than at T 3，but those of group D were significantly lower than the group C at T 3（P＜0.05）；there was no statistical significance in the levels of serum NSE or S 100β protein between 2 groups at T 1（P＞0.05）. The recovery time of anesthesia，the amount of nitroglycerin ，the incidence of tachycardia ，nausea and vomiting ，restlessness，shivering and cough in group D were significantly shorter or lower than group C （P＜0.05）；there was no statistical significance in the intraoperative blood loss between 2 groups（P＞0.05）. CONCLUSIONS ：Dexmedetomidine can maintain the hemodynamic stability of patients with intracranial aneurysm embolization during the perioperative period ，has little effect on rSO 2 and brain function ，and has good safety.

APC model analysis of lung cancer death trend in residents of Macheng City, Hubei Province, 1984-2018 / 公共卫生与预防医学

Objective To study the trends of lung cancer mortality among adult residents in Macheng City, Hubei Province from 1984 to 2018． Methods Mortality data was extracted from Macheng City disease surveillance points (DSPs) system and China Demographic Yearbook. The age-period-cohort (APC) model and Intrinsic Estimator algorithm were used to estimate the age effect, period effect and cohort effect of lung cancer mortality. Results The age effect coefficient of lung cancer mortality increased with age from 20 to 74 years old. The mortality risk of the 70-74 group was 42.62 times that of the 20-24 group. The period effect coefficient of lung cancer mortality also continued to rise with time. The cohort effect coefficient was parabolic, and residents born in 1939-1943 had the highest coefficient (1.298 4). Conclusion The risk of lung cancer death of adult residents in Macheng City significantly increased with the year and the rapid development of socio-economics.

Experimental study and reflection on peacetime and wartime reconstruction of large general hospitals in public health emergencies / 中南大学学报(医学版)

To propose the architectural layout for the big general hospital in the face of public health emergencies, we analyzed the conditions, methods, problems and countermeasures for the reconstruction of the isolation ward from the existing medical building layout of a general hospital. The affected areas met the requirements of isolation ward in the reconstruction, and realized the corresponding partition and separation of people. But the cost of occupying the medical room should be concerned. General hospital should be alerted to potential risks of public health emergencies. The characteristics of different construction types, defects, and the function of the hospital should be considered in the construction, rebuilding, and expansion of the hospital, which shouldnot only meet the needs of the development of the hospital daily usage but also consider dealing with emergent public health events. We can adopt the reasonable layout, including setting up a firewall-like device between the channel and the floor, an ordinary ward at ordinary times, and an independent space for emergency by pulling down the gate. This strategy can not only avoid the problem of low utilization rate of the space occupied by the corresponding area in the ward for diseases spread by air and droplets, maximizing the efficiency of the medical site, but also avoid the problem of emergency response to the temporary reconstruction.