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The appropriate needle device is crucial for obtaining the curative effect of fire needling therapy. The article introduces the material specification, clinical operation, indications, characteristics and advantages of the contemporary traditional fire needling devices (e.g. He's fire needle and Shi 's fire needle) and the contemporary new-type ones (e.g. fire needling with filiform needle and micro-needle); and determines the innovations of modern fire needling. It is anticipated that the needle specifications, production process and operation standard of fire needling devices should be further unified so as to provide the references for the selection of fire needling devices in treatment based on clinical syndrome differentiation and expand the clinical application of fire needling therapy.
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Humains , Mâle , Points d'acupuncture , Thérapie par acupuncture , AiguillesRésumé
The increasing prevalence of chronic kidney disease (CKD) is a major global public health concern. Despite the complicated pathogenesis of CKD, renal fibrosis represents the most common pathological condition, comprised of progressive accumulation of extracellular matrix in the diseased kidney. Over the last several decades, tremendous progress in understanding the mechanism of renal fibrosis has been achieved, and corresponding potential therapeutic strategies targeting fibrosis-related signaling pathways are emerging. Importantly, extracellular vesicles (EVs) contribute significantly to renal inflammation and fibrosis by mediating cellular communication. Increasing evidence suggests the potential of EV-based therapy in renal inflammation and fibrosis, which may represent a future direction for CKD therapy.
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【Objective】 To analyze the root causes of adverse events to insufficient plasma transfusion, so as to explore improvement measures, optimize the transfusion strategy and avoid such adverse events. 【Methods】 The root causes of insufficient plasma transfusion were analyzed by health care failure mode and effect analysis, the targeted improvement measures were formulated and the effect was evaluated. 【Results】 After the improvement, the incidence of adverse events to insufficient plasma transfusion decreased significantly.The risk priority value affecting the safety of blood transfusion decreased from 70 to 8, and the proportion of coagulation function test after blood transfusion increased from 44.61%(1 309/2 934)in 2012 to 80.55% (2 187/2 715)in 2019, and plasma transfusion volume per capital increased from 300 mL to 528 mL. PT and APTT values after plasma transfusion in 2019 significantly increased compared with those in 2012. Meanwhile, the proportion of plasma transfusion in hospitalized patients decreased from 3.16% (2 934/92 838)to 2.12%(2 715/128 352). 【Conclusion】 Risk management of quality and safety of blood transfusion by combing healthcare failure mode, effect analysis and root cause analysis(RCA) can improve the risk awareness of clinical blood transfusion, optimize the proportion of plasma transfusion, and is essential to ensure the safety and effectiveness of blood transfusion and improve the prognosis of transfused patients.
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To study Ginkgo biloba leaves in different producing area, we establish an HPLC method for the simultaneously determination of seven flavonoids glycosides and four biflavonoids in G. biloba leaves. The analysis was performed on an Agilent ZORBAX SB-C₁₈ column(4.6 mm×250 mm, 5 μm) wich acetonitrile, and 0.4% phosphoric acid as mobile phase at flow rate of 1 mL•min⁻¹ in a gradient edution, and the detection was carried out at 254 nm.The calibration curves of the seven flavonoids glycosides and four biflavonoids had a good linearitiy with good recoveries. The established HPLC method is simple, rapid, accurate, reliable, and sensitive, and can be applied to the identification and quality control of G. biloba leaves.
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Based on the relationship between government and market,this paper analyzed the development process of large medical equipment configuration management strategy,and forecasted the trend of management.It is found that the development process of large equipment management in China can be divided into four stages:sprouting stage,management window period,growth stage,and transition period.The management model of the four stages,respectively,are integrated management,market-oriented management,quantitative control-based comprehensive supervision,and legal supervision.As per the analysis of this work,it was found that the sprouting of the regulation of industry standards,training professionals,management efficiency are low;market-oriented led to rapid growth in the number of equipment,with a low configuration efficiency;growth period of the number of regulatory norms of the market and equipment is reasonable to use;and the legal supervision in transition is taking shape.Currently,the lack of rational allocation of large-scale equipment in the hospitals is the main factor leading to market failure.In the legal framework,the government intervention with configuration permits is the major large-scale equipment configuration management model in the future.
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Based on the relationship between government and market,this paper analyzed the development process of large medical equipment configuration management strategy,and forecasted the trend of management.It is found that the development process of large equipment management in China can be divided into four stages:sprouting stage,management window period,growth stage,and transition period.The management model of the four stages,respectively,are integrated management,market-oriented management,quantitative control-based comprehensive supervision,and legal supervision.As per the analysis of this work,it was found that the sprouting of the regulation of industry standards,training professionals,management efficiency are low;market-oriented led to rapid growth in the number of equipment,with a low configuration efficiency;growth period of the number of regulatory norms of the market and equipment is reasonable to use;and the legal supervision in transition is taking shape.Currently,the lack of rational allocation of large-scale equipment in the hospitals is the main factor leading to market failure.In the legal framework,the government intervention with configuration permits is the major large-scale equipment configuration management model in the future.
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Objective To establish a method for the preparative separation and isolation of the epimeric labdenetriols,phy?sanicantriol(1)and 14-epi-physanicantriol(2),from the leaves of Artemisia argyi.Methods The CH2Cl2fraction of 95% EtOH ex?tract from the leaves of A.argyi was separated by Diaion HP-20,silica gel and Sephadex LH-20 column chromatography and purified by semi-preparative HPLC to obtain an epimeric mixture of 1 and 2.Then,the epimeric mixture was separated by silica gel H column chromatography with eluting by n-hexane-CH2Cl2-isopropyl alcohol(1:1:0.15,V/V/V)to obtain compounds 1 and 2.The structures of 1 and 2 were identified by comparing MS and NMR data with those reported in the literature.Results and Conclusion Two diterpe?noids were isolated for the first time from the family Compositae.This method is effective,convenient and rapid,and is suitable for the separation and preparation of the epimers 1 and 2.
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Angelica sinensis(Umbelliferae)is a worldwide-known medicinal plant and also a famous traditional Chinese medicinal herb. It is recorded to possess the efficacy of enriching the blood and invigorating the circulation of blood of the individual.Danggui was extensively applied to the treatment of gynecological disorders. Modern researches indicate that phthalides are main chemical components related to the bioactivities of A.sinensis, such as anti-tumor, analgesic and neuroprotective effect.The advances in studies on the structures and pharmacological activities of phthalides from A.sinensis are reviewed to provide references for further researches and utilization of their medicinal value.
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The traditional Chinese medicine (TCM) as a treasure of the Chinese history, has deposited lots of precious experience and valuable data. As an effective mean of data processing and knowledge discovery, data mining and complex networks are used to describe the data from the statistics and complexity, and are widely used in the research of modern TCM. Data mining bias to explore the surface of the statistical law, lack for an in-depth discussion of the inner mechanism of the system; While the complex network mainly describes the system structure through the perspective of network and good at exploring the universal law in the functional complexity, but there are limitations in the large data processing. To analyze on the applications and problems of data mining and complex networks in the field of TCM, give two methods and frame of paradigms integration, construct Chinese medicine property development network in case of cerebral vascular disease, and excavate the regularity of compatibility of TCM combined with pharmaceutical association and improved COPRA algorithm. The experimental results show that the method can effectively explore the association rules of the infrequent itemsets, and provide the basis for the compatibility of Chinese herbal medicine.
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Intrinsic or acquired chemo-resistance is the main reason for chemotherapy failure, and thus finding ways to reverse chemo-resistance has become an interesting topic for research. Studies have revealed that immunomodulatory molecules are involved in cancer chemo-resistance. Hence, interventions that target immunomodulatory molecules to reverse chemo-resistance have attracted a great deal of concern from domestic and foreign scholars. Immunomodulatory molecules, such as PD-L1, B7-H3, HMGB1, TRAIL, MyD88, and Cytokines (TNF-α, IFN-α, IL-6), have been proven to take part in regulating immune function and tumor drug-resistance characteristics, thereby providing new ideas to the reversal of tumor chemo-resistance. This artide reviews the progression of immuno-modulatory molecules with the change in cancer chemotherapy sensitivity to provide a theoretical basis for the application of new thera-peutic regimen of bio-chemotherapy.
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<p><b>OBJECTIVE</b>To explore the mechanism of tanshinol on alleviate the inflammatory injury of lung tissue in rat hepatopulmonary syndrome (HPS).</p><p><b>METHODS</b>SD rats were randomly divided into normal control group (n = 8), hepatopulmonary syndrome (HPS) group (n = 11) and tanshinol intervention group (n = 9). HE staining was used to observe the histopathology changes of pulmonary and hepatic tissues, and to count the number of macrophages in lung tissues. The activity of alanine transferase (ALT) and concentrations of endotoxin, tumor necrosis factor-a (TNF-alpha) and homocystein (Hcy) in plasma were detected. The concentrations of TNF-alpha, nitric oxide (NO) and malondialdehyde (MDA) and the activity of inducible nitric oxide synthase (iNOS) in the lung tissues were measured, respectively.</p><p><b>RESULTS</b>Thickened alveolar septum and increased macrophages were observed in lungs in HPS rat. After administered with tanshinol, the pulmonary pathological changes were alleviated and the number of macrophages in lung tissue was decreased compared with HPS group. The activity of ALT and the concentrations of endotoxin, TNF-alpha and Hcy in plasma ,and TNF-alpha, iNOS, NO and MDA in lung tissue in HPS group were higher than those of normal control group; meanwhile, those tanshinol group were less those that of HPS group.</p><p><b>CONCLUSION</b>Tanshinol may play an important role in delaying the development of HPS through protecting liver or directly antagonizing the effect of intestinal endotoxemia so as to alleviate the inflammatory reaction in lung tissue.</p>
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Animaux , Mâle , Rats , Alanine transaminase , Métabolisme , Acides caféiques , Pharmacologie , Modèles animaux de maladie humaine , Endotoxines , Sang , Syndrome hépatopulmonaire , Traitement médicamenteux , Anatomopathologie , Homocystéine , Sang , Foie , Anatomopathologie , Poumon , Anatomopathologie , Macrophages , Anatomopathologie , Malonaldéhyde , Métabolisme , Monoxyde d'azote , Métabolisme , Nitric oxide synthase type II , Métabolisme , Rat Sprague-Dawley , Facteur de nécrose tumorale alpha , SangRésumé
Objective To investigate the effects of physicochemical factors on the growth and total flavonoids accumulation of Saussurea involucrata. Methods The dry weight and total flavonoids accumulation in multiple seedings of S. involucrata were measured. Results The optimal cultural condition for the growth and total flavonoid accumulation of S. involucrata was as following: MS culture medium adding 6-BA 0.5 mg/L + NAA 0.05 mg/L, 40 mmol/L of nitrogen source, NH4+-NO3- (15 : 25), 40 g/L of carbon sucrose, pH values 5.0-6.0, illumination intensity of 2 500 Ix, temperature 25°C. Conclusion The optimal culture conditions could significantly improve the growth and total flavonoids accumulation of S. involucrata. And the nitrogen, carbon, and temperature have the most obvious effects on the growth and total flavonoids accumulation of S. involucrata.
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Objective To observe the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve that were combined to design a compound muscle flap.And to observe the effect of this flap clinical application.Methods Ten adult and fresh cadaver lower limbs were observed the anatomic relationship between the lateral sural artery perforators and the nutrient vessels of the lateral sural cutaneous nerve,and were combined to design a compound muscle flap.Clinically applied in 5 cases,and the flap sizes ranged from 6 cm × 9 cm to 9 cm × 12 cm.Results After into the muscle,the lateral sural artery issued 3-5 perforating branches (OD:0.2-1.8 mm) along the way,which provided nutrition for the lateral head of the gastrocnemius and the surrounding skin and involved in the formation of shallow and deep fascia vascular network with the nutrient vessels of the lateral sural cutaneous nerve.From Feburary 2009 to November 2011,the compound pedicled muscle flap were clinically applied in 5 cases to repair the skin defects of the anterior knee and proximal tibia.Flaps in 4 cases completely survivedand 1 case had partial superficial necrosis on the distal part of the flap,which healed after dressing change.Conclusion The compound pedicled muscle flap has two sets of blood supply that could expand the area of the flap,which could guarantee its feeling.This kind of flap could repair the complicated skin and soft tissue defects around the knee joint.
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<p><b>OBJECTIVE</b>To identify the genetic susceptibility to Kashin-Beck disease (KBD) and explore the interaction between low selenium (Se) and the susceptibility gene loci in KBD.</p><p><b>METHODS</b>The DNA samples collected from 23 KBD nuclear families were analyzed using PCR and GeneScan Analysis 3.7 and Genotyper3.7 software. The haplotype relative risk (HRR) and transmission disequilibrium test (TDT) were used to test the data of the genotypes. The serum selenium (Se) concentration was measured by atomic fluorescence spectrometry, and the interaction between low Se and the susceptibility loci was calculated using a binary logistic regression.</p><p><b>RESULTS</b>In the 23 nuclear families, the alleles of D2S151 (248 bp), D2S305 (320 bp), and D11S4094 (194 bp) showed significant correlation to KBD (P<0.05). Serum Se concentrations in the studied individuals was 0.037 µg/ml. No significant statistical interaction was observed between low Se exposure and the susceptibility loci (P>0.05).</p><p><b>CONCLUSION</b>The polymorphisms in the STR loci D2S305, D2S151, and D11S4094 or the polymorphism loci near them might been related to KBD susceptibility. Low Se exposure shows no significant interaction with the susceptibility loci.</p>
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Adolescent , Adulte , Enfant , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Allèles , Fréquence d'allèle , Prédisposition génétique à une maladie , Génotype , Maladie de Kashin-Beck , Sang , Génétique , Répétitions microsatellites , Pedigree , Sélénium , SangRésumé
This study was designed to investigate the value of 3-D optical coherence tomography [3-D OCT] combined with fundus photochromy in the diagnosis of acute central serous chorioretinopathy [CSCR]. 3-D OCT and fundus photochromy were performed on 30 patients [36 eyes] with acute CSCR. Fluorescein angiography [FA] was also performed to confirm the diagnosis and to obtain the fluorescein leakage sites. 22 eyes presented neurosensory retinal detachment determined by 3-D OCT [28 leakage spots], 1 eye showed retinal pigment epithelium [RPE] detachment [2 leakage spots], and 13 eyes showed both neurosensory and RPE detachment [17 leakage spots]. 3-D OCT showed significant changes in the RPE in 36 of 47 leakage spots [76.6%]. Fundus photochromy showed white-gray changes in 22 of the 47 leakage spots [59.6%]. 47 leakage spots were identified by FA in 36 eyes. The combination of 3-D OCT and fundus photochromy identified 42 of the 47 leakage spots [89.4%] spotted by FA. A combination of 3-D OCT and fundus photochromy offered a high identification rate of the leakage spots. The combination of the two noninvasive techniques may be used as an alternative diagnostic or evaluation tool for acute CSCR
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Humains , Tomographie par cohérence optique/méthodes , Angiographie fluorescéinique/méthodes , Rétinopathies/diagnostic , Vaisseaux rétiniens/anatomopathologie , Exsudats et transsudatsRésumé
In medical education,the application of discussion of teaching reform can enhance medical students'interest in learning,stimulate their innovative thinking,develop their clinical thinking and critical thinking.improve their psychological quality and language skills and improve knowledge and comprehensive quality of teachers as well.
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Objective To investigate the clinical efficiency of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial.Methods From February 2006to March 2010,according to the position and size of the soft tissue defects,the muscle flap combined with branch artery of the sural medial gastrocnemius and sural nerve nutritional vessel axial were desingned and obtained to repair 7 cases of sofi tissue defects of the upper-region of the tibial.The flap size ranged from 8.0 cm × 8.0 cm to 12.0 cm × 10.0 cm.The vessel pedicle of branches ranged from 1.8-3.0 cm.The distribution of the vessel pedicle of branches ranged from 10.0-17.0 cm on the distant popliteal fossa,and ranged from 2.0-5.0 cm on the back of medial line.Results The outline and function were satisfactory during 6-15 months follow-up.Conclusion The blood supply of this flap is reliable without sacrifice of major arteries.Flap elevation is easy.It can transfer to a long distance and can repair large skin defects.It is very useful in repairing upper-region of the tibial large soft tissue defect.
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At present, there is a relative shortage of multimedia classroom resources of medical schools. Yan'an Hospital of Kunming Medical College proposed the new model of teaching methods of portable multimedia classrooms composed of MP5. According to the teaching practice and the results from the questionnaire, it is approved by the teachers and students.
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BackgroundLimbal stem cell deficiency usually leads to blindness, and traditional therapy is limited. Recent research demonstrated that bone mesenchymal stem cells ( BMSCs ) and human amniotic epithelial cells(AECs) could differentiate into many kinds of cells including corneal epithelial cells, but the outcome and effect of these cells on corneal stem cell deficiency are still unclear. ObjectiveThis study aimed to observe and compare the effects of rabbit BMSCs and human AECs transplantation for rabbit limbal stem cell deficiency. Methods Eighteen clean New Zealand rabbits were randomly divided into the amniotic stroma(AS) group, rabbit BMSCs group and human AECs group with 6 rabbits for each group. Limbal stem cell deficiency models were established by putting a piece of filter paper that had been soaked in a NaOH solution at the corneal center. Rabbit BMSCs were isolated and purified by density gradient centrifugation combined with the attachment culture method, and human AECs were collected by a sequential trypsin digestion technique,and the third generation rabbit BMSCs and the first generation human AECs were identified with RT-PCR. After that,cells were inoculated onto the denuded AS and grafted to the corneal surface of the experimental animals. Twenty-eight days after cell transplantation, the therapeutic effects were evaluated based on the corneal neovascularization and opacity scores. Corneal histopathological examination and immunohistochemistry were performed to evaluate and compare the effectiveness among AS,rabbit BMSCs and human AECs on corneal stem cell deficiency. The procedure complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. ResultsThe third generation of rabbit BMSCs grew well after 12 hours, and the first generation of human AECs formed a membrane-like monolayer after 48 hours of incubation on AS. Immunohistochemistry staining showed that, 28 days after transplantation, the surface cells of the cornea were positive for cytokeratin 3 in both the rabbit BMSCs group and human AECs group.Compared with the AS group,the corneal neovascularization and opacity grades were significantly decreased in the rabbit BMSCs group( Z=-2. 983, P =0. 003 ; Z =-2. 844, P =0. 004 ) and human AECs group ( Z =-2. 817, P =0. 005 ; Z =-2.041, P =0. 041 ). Histopathological analysis exhibited that stratified corneal epithelial-like cells formed on the corneal stroms 28 days after grafting and no signs of goblet cells and neovascularization were found. Less inflammatory cells and regular collagen fiber could be seen in the rabbit BMSCs group and human AECs group. In addition,clinical observation also revealed that the corneas were much clearer in the rabbit BMSCs group than the human A ECs group( Z =-2. 091 , P=0. 037 ), but the corneal neovascularization score was similar between them (Z = -0. 267,P=-0. 789). ConclusionsRabbit BMSCs and human AECs can differentiate into corneal epithelial-like cells onthedamagedcornealsurfaceandfurtherdemonstrateremarkableinhibitoryeffectsoncornealneovascularization and inflammatory cells. The more dominant and prominent effect is the role played by rabbit BMSCsin the improvement of corneal transparency.
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Teachers are the most important resources of colleges and univesities. Setting up the teachers' competence model of medical colleges and universities is the basis of guaranting the quality of medical education, which accords with the need of the post training of teachers and can be the basis for teachers' competence assessment.