Application of teach-back-based role transition shock model in knee arthroplasty nursing internship teaching / 中华医学教育探索杂志

Objective:To explore the application of a role transition shock model based on the teach-back technique in knee arthroplasty nursing teaching.Methods:We assigned 50 nursing student interns practicing in the knee arthroplasty team of Orthopedics Department of Nanjing First Hospital between August 2020 and August 2022 into control group ( n=25, traditional teaching) and observation group ( n=25, teach-back-based role transition shock model teaching) according to the order of admission. At the end of internship, the examination scores, the impact of transition shock on comprehensive abilities, and teaching satisfaction of the students were assessed and analyzed using the t test and Fisher's exact test with the use of SPSS 22.0. Results:Compared with the control group, the observation group scored significantly lower in the physical, psychological, knowledge and skills, and sociocultural and developmental dimensions of the transition shock assessment scale ( P<0.05). The observation group showed significantly higher scores of nurse-patient communication, nursing practice, disease observation, health education, humanistic care, team cooperation, clinical thinking, and emergency response than the control group ( P<0.05). The examination results of the observation group were significantly better than those of the control group ( t=12.31, 11.52, P<0.001). The teaching satisfaction rate of the observation group was significantly higher than that of the control group [100.00% (25/25) vs. 68.00% (17/25), χ2=9.52, P=0.002]. Conclusions:The teach-back-based role transition shock model can help alleviate the transition impact faced by nursing student interns when entering clinical practice, and also improve their comprehensive abilities as well as satisfaction with teaching.

UHPLC-Q-TOF/MS Analysis of the Active Components of Total Flavonoids Extracts from Sarcandra glabra in Promoting Megakaryocyte Differentiation / 中药新药与临床药理

Objective To screen the active components of total flavonoid extracts of Sarcandra glabra to promote megakaryocyte differentiation.Methods(1)A model of megakaryocyte differentiation disorder was established by co-culturing human megakaryocytic leukaemia cells(Dami)with human bone marrow stromal cells(HS-5)as an evaluation system,and the experimental groupings were as follows:the Dami group(Dami),the control group(Dami+HS-5),and the PMA group[Dami+HS-5+5 ng·mL-1 foprolol 12-tetradecanoate 13-acetate(PMA)],and model group[Dami+HS-5+1%rabbit anti-rat platelet serum(APS)+5 ng·mL-1 PMA]were cultured for 48 hours.The expressions of megakaryocyte differentiation and maturation surface marker molecules,CD41a and CD61 were detected by flow cytometry.(2)Forty-nine SD male rats were randomly divided into blank plasma group,15-minute group,30-minute group,60-minute group,90-minute group,120-minute group,and 240-minute group,with 7 rats in each group.The rats in each administration group were gavaged with 1.26 g·kg-1 of total flavonoids extracts of Sarcandra glabra,and blood was collected at six set time points(15,30,60,90,120,240 minutes)for the preparation of time-dependent serum-containing plasma of total flavonoids extracts of Sarcandra glabra.(3)Ultra-high performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry(UHPLC-Q-TOF/MS)was used to analyze the plasma of the time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra,and the peak area was used to construct a matrix(X-matrix)of the amount of chemical composition change over time in the time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra.The collected time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra at six different time points was used to intervene in the model of megakaryocyte differentiation and maturation disorder,and the expression of cell surface molecules CD41a and CD61 was detected by flow cytometry to construct the matrix of effect of time-dependent serum-containing plasma of the total flavonoids extracts of Sarcandra glabra(Y-matrix).(4)After the data of X and Y matrices were standardized,partial least squares(PLS)was used to calculate and analyze the quantitative and qualitative effect relationship,and variable importance for projection(VIP)>1 was used as the threshold to screen the effect components related to the changes of cell surface molecules CD41a and CD61,and chemical composition identification,as the potential effector components in the total flavonoid extracts of Sarcandra glabra were used to promote the differentiation of megakaryocytes,and finally the regression evaluation system was used to verify the efficacy of its medicinal effect.Results(1)Compared with the Dami group,the expression level of CD41a on the surface of Dami cells in the control group was significantly increased(P＜0.05).Compared with the control group,the expression levels of CD41a and CD61 on the surface of Dami cells in the PMA group were significantly increased(P＜0.01).Compared with the PMA group,the expression levels of CD41a and CD61 on the surface of Dami cells in the model group were significantly reduced(P＜0.01).(2)Compared with the blank plasma group,the expression levels of the molecules CD41a and CD61 on the surface of Dami cells at each time point of 15,30,60,90,120,and 240 minutes were significantly increased(P＜0.01),and the expression levels of CD41a and CD61 were both highest in the 30-minute group.The potential effective components with VIP value greater than 1 were screened out in the positive and negative ion mode,and 540.3638@12.25 and 559.2991@11.53 were selected for pharmacodynamic verification.559.2991@11.53 was identified as daucosterol(Dau),540.3638@12.25 was identified as rosmarinic acid 4-O-β-D-glucoside(Ros).After Ros and Dau intervened in the megakaryocyte differentiation and maturation disorder model respectively,the expression levels of CD41a and CD61 on the surface of Dami cells in the low-,medium-and high-dose groups(40,60 and 80 μg·mL-1)of Ros and Dau were significantly increased compared with the model group(P＜0.05,P＜0.01).Conclusion Ros and Dau may be the active components of the total flavonoids extracts of Sarcandra glabra to promote the differentiation of megakaryocytes.

Treatment of Chronic Bronchitis Based on Theory of "Warming Lung Yang and Protecting Yin Skin" / 中国实验方剂学杂志

Chronic bronchitis （CB） is a common respiratory system disease that is classified as a lung disease in traditional Chinese medicine （TCM） and is closely related to lung dysfunction. Lung Yang is the Yang Qi of the lungs，which drives the physiological activities within the lungs. It has physiological functions such as warming the lung system，regulating lung fluid，and dispersing the protective Yang. It can be distributed on the surface of the airway's Yin skin through sweat pores in the form of airflow and fluid，playing a protective and nourishing role. If the protective Yang fails to guard the Yin skin or if the lung fluid cannot nourish the Yin skin，the structural integrity of the airway's Yin skin may be compromised. This may weaken lung Yang's functions， such as clearing phlegm turbidity，dispersing lung fluid，and resisting external pathogens. Consequently， the retention of phlegm turbidity，insufficient nourishment of the Yin skin，and invasion by external pathogens all damage the lung Yang，burn the lung fluid，and exacerbate the pathological state of Yin skin unprotected，forming a vicious cycle that ultimately results in lung Yang asthenia and then the onset of CB. Based on the intrinsic connection between "Yin skin unprotected" and "lung Yang asthenia"，this paper interprets the etiology and pathogenesis of CB. It proposes that "Yin skin unprotected" in the airway is the basic cause of CB and "lung Yang asthenia" caused by "Yin skin unprotected" is the core pathogenesis of CB. By integrating micro differentiation indicators with macro differentiation syndromes， the study explores its modern biological basis. Guided by the theory of "warming the lung Yang and protecting the Yin skin" and based on modern pharmacology research，this study further explores the scientific connotation of single TCM and compound formulations for treating TCM by warming the lung Yang and protecting the Yin skin. Furthermore， it proposes methods for dispelling pathogenic factors and protecting the Yin skin during the acute exacerbation phase，as well as nourishing and warming lung Yang during the remission phase，in order to provide new ideas for the early prevention and treatment of TCM.

Research on Automatic Microalgae Detection System Based on Deep Learning / 生物化学与生物物理进展

ObjectiveThe scale of microalgae farming industry is huge. During farming, it is easy for microalgae to be affected by miscellaneous bacteria and other contaminants. Because of that, periodic test is necessary to ensure the growth of microalgae. Present microscopy imaging and spectral analysis methods have higher requirements for experiment personnel, equipment and sites, for which it is unable to achieve real-time portable detection. For the purpose of real-time portable microalgae detection, a real-time microalgae detection system of low detection requirement and fast detection speed is needed. MethodsThis study has developed a microalgae detection system based on deep learning. A microscopy imaging device based on bright field was constructed. With imaged captured from the device, a neural network based on YOLOv3 was trained and deployed on microcomputer, thus realizing real-time portable microalgae detection. This study has also improved the feature extraction network by introducing cross-region residual connection and attention mechanism and replacing optimizer with Adam optimizer using multistage and multimethod strategy. ResultsWith cross-region residual connection, the mAP value reached 0.92. Compared with manual result, the detection error was 2.47%. ConclusionThe system could achieve real-time portable microalgae detection and provide relatively accurate detection result, so it can be applied to periodic test in microalgae farming.

Influence of SBAR communication mode intervention on patients with heart failure / 心血管康复医学杂志

Objective:To study influence of Status-Background-Assessment-Recommendation(SBAR)communi-cation mode intervention on patients with heart failure(HF).Methods:According to intervention method,a total of 187 HF patients treated in our hospital were divided into routine intervention group(n=96,received routine in-tervention based on routine treatment)and SBAR group(n=91,received SBAR communication mode intervention based on routine treatment).Both groups were intervened for six months.General clinical data,LVEF,left ven-tricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),scores of Morisky medi-cation compliance scale and the medical outcomes study 36-item short-form heath survey(SF-36),patients'satis-faction and incidence rate of major adverse cardiovascular events(MACE)within six-month follow-up were com-pared between two groups.Results:Compared with routine intervention group,after intervention,there were sig-nificant rise in LVEF[(53.44±2.11)%vs.(57.72±1.80)%],scores of Morisky medication compliance scale[(2.00±0.77)scores vs.(3.63±1.07)scores]and SF-36[(68.83±7.62)scores vs.(76.81±9.68)scores],and significant reductions in LVEDV[(132.63±5.59)ml vs.(119.15±6.89)ml]and LVESV[(64.36±5.82)ml vs.(56.62±4.21)ml]in SBAR group(P=0.001 all).Patients'satisfaction of SBAR group was significantly higher than that of routine intervention group(89.01%vs.73.96%,χ2=6.958,P=0.008),and incidence rate MACE during follow-up was significantly lower than the latter(5.49%vs.15.63%,LogRankχ2=5.043,P= 0.025).Conclusion:SBAR communication mode intervention can significantly improve heart function,medication compliance and quality of life in patients with heart failure,with high patients'satisfaction.

Biomanufacturing of bioactive compounds: current situation, challenges, and future perspectives / 生物工程学报

Biomanufacturing uses biological systems, including cells, microorganisms, and enzymes, to produce natural or synthetic molecules with biological activities for use in various industries, such as pharmaceuticals, cosmetics, and agriculture. These bioactive compounds are expected to play important roles in improving the quality of life and prolonging its length. Fortunately, recent advances in synthetic biology and automation technologies have accelerated the development of biomanufacturing, enabling us to create new products and replace conventional methods in a more sustainable manner. As of now, the role of biomanufacturing in the growth and innovation of bioeconomy is steadily increasing, and this techbology becomes a prevalent technology in global markets. To gain a comprehensive understanding of this field, this article presents a retrospective review of Bloomage Biotechnology's Research and Development and briefly reviews the developments of biomanufacturing and offers insights into the futre prospects. In conclusion, biomanufacturing will continue to be an important, environmentally friendly, and sustainable production mode in the ongoing development of bioeconomy.

Congenital pulmonary alveolar proteinosis in a neonate / 中国当代儿科杂志

The male patient was referred to the hospital at 44 days old due to dyspnea after birth and inability to wean off oxygen. His brother died three days after birth due to respiratory failure. The main symptoms observed were respiratory failure, dyspnea, and hypoxemia. A chest CT scan revealed characteristic reduced opacity in both lungs with a "crazy-paving" appearance. The bronchoalveolar lavage fluid (BALF) showed periodic acid-Schiff positive proteinaceous deposits. Genetic testing indicated a compound heterozygous mutation in the ABCA3 gene. The diagnosis for the infant was congenital pulmonary alveolar proteinosis (PAP). Congenital PAP is a significant cause of challenging-to-treat respiratory failure in full-term infants. Therefore, congenital PAP should be considered in infants experiencing persistently difficult-to-treat dyspnea shortly after birth. Early utilization of chest CT scans, BALF pathological examination, and genetic testing may aid in early diagnosis.

Two cases of brucellosis complicated with liver abscess or pancytopenia / 中华全科医师杂志

Two brucellosis patients with rare complications are presented in this report. In case 1, abdominal CT showed two liver abscesses with the maximum diameter>5.0 cm, no puncture and drainage were given. After treatment with anti brucellosis drugs, the abscess lesions disappeared completely. Case 2 had pancytopenia, the platelet count was reduced to 14×10 9/L. After anti brucellosis drug treatment the peripheral blood routine returned to normal. These two cases of rare complications of brucellosis suggests that early identification, diagnosis and treatment can improve the clinical outcomes of the patients.

Application and mechanism of nanomedicine in antifungal infection therapy / 药学学报

The threat of fungal diseases is increasingly rigorous. The clinically invasive fungal infections remain a main cause of morbidity and mortality in certain high-risk groups, especially in critical patients or immunocompromised patients. In drug therapy, the problems of off-target toxicity and antifungal drug resistance are still challenging. With the wide application of biomaterials and nanotechnology, more nanomedicine studies have been carried out on antifungal drugs, such as the amphotericin B liposome which greatly reduced the renal toxicity of drugs has been successfully marketed. For the unique physical and chemical properties, the nano-drug delivery system possessed great potential in improving the bioavailability, reducing the side effects of drugs, increasing the stability of drugs, and achieving cells or tissue-specificity through the modification. This review summarized the applications and limitations of antifungal drugs. Some nanomedicines were summarized in discussion oriented around the antifungal therapy, including liposomes, niosomes, lipid nanoparticles, polymer nanoparticles, microemulsion, dendrimers, inorganic nanocarriers. Nanotechnology and nano-drug delivery system provide promising strategies for the research and development of new formulations that can improve antifungal activity and possibly overcome antifungal drug resistance.

Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method / 中华传染病杂志

Objective@#To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.@*Methods@#A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.@*Results@#The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189).@*Conclusion@#This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method / 中华传染病杂志

Objective:To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig)M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.Methods:A total of 278 patients who were respectively treated at Wuhan Hankou Hospital and the People′s Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with positive 2019-nCoV nucleic acid, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant nuclear protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.Results:The positive rates of IgM and IgG with the colloidal gold detection in confirmed patients with positive 2019-nCoV nucleic acid were 78.7%(70/89) and 73.0%(65/89), respectively. The positive rates of IgM and IgG in medical examiners were 1.8%(5/273) and 0.7%(2/273), respectively. The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8%(113/189) and 52.9%(100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1%(125/189).Conclusion:This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Motor Control Function of Brain in Subacute Complete Spinal Cord Injured Patients: A Functional Magnetic Resonance Imaging Study / 中国康复理论与实践

Objective:To study the changes of brain motor control function in patients with complete spinal cord injury within three to six months. Methods:From January, 2017 to January, 2019, eleven inpatients with complete spinal cord injury and twelve healthy controls were screened with functional magnetic resonance imaging during attempted/executive movement (MA/ME) and motor imagery (MI). The involved area and activation were compared between the groups under tasks. Results:More areas were activated in the patients than in the controls as MA/ME, such as bilateral primary sensorimotor cortex, supplementary motor area, lateral globus pallidus, cerebellum, contralateral thalamus and putamen. During MI, the activation was more in the patients in ipsilateral primary motor cortex, supplementary motor area, dorsal premotor area, contralateral supplementary motor area, insular and basal ganglia. The patients induced more activation as MA than as MI in ipsilateral primary motor cortex, bilateral supplementary motor area and cingulate motor area, and contralateral cerebellum. Conclusion:The activation remains normal in primary motor cortex and supplementary motor area for subacute complete spinal cord injury patients when undergoing motor tasks, but some reorganization may occur in parietal lobe and cerebellum that involve in sensorimotor integration.

Impact of Herbal Preparations on Outcomes of Highly Active Antiretroviral Therapy: A One-Year Prospective Cohort Study / 中国结合医学杂志

OBJECTIVE@#To investigate the impacts of two herbal preparations for human immunodeficiency virus/aquired immune deficiency syndrome (HIV/AIDS) patients, Shenling Fuzheng Capsule (, SLFZC) and Qingdu Capsule (, QDC), on the efficacy of highly active antiretroviral therapy (HAART).@*METHODS@#HIV/AIDS patients met the criteria were all enrolled in a 1-year cohort study, in which patients receiving HAART alone were designated as Group A, those receiving HAART in combination with SLFZC were designated as Group B, and those receiving HAART in combination with QDC were designated as Group C, 100 cases in each group. The dose of SLFZC was 1.48 g (4 capsules), 3 times daily, and QDC 1.56 g (4 capsules), 3 times daily. T cell subsets, HIV RNA and HIV-1 drug resistance were detected at enrollment and 1 year after treatment. Patients were followed up every 3 months, during which side-effects and other clinical data were recorded.@*RESULTS@#After 1-year treatment, the median increment in CD counts was 165.0, 178.0 and 145.0 cells/μL for Group A, B and C, respectively. HIV RNA was undetectable in 94% of patients in Group A, 96% in Group B and 92% in Group C. There were no differences regarding the increment in CD counts, HIV RNA and frequency of HIV-1 drug resistance mutations. Two of the 14 suspected side-effect symptoms, i.e. fatigue and dizziness, were lower in Groups B and C than in Group A (P<0.05, respectively) CONCLUSIONS: SLFZC and QDC do not have a negative impact on immunological and virological response to HAART; however, these preparations are not as potent in reducing HAART-associated side-effects as anticipated.

Treatment of anterior glenohumeral dislocations with manual reduction of WU medical school / 中国骨伤

OBJECTIVE@#To investigate the technique, mechanism and clinical efficacy of manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations.@*METHODS@#From January 2016 to December 2017, 181 patients with anterior glenohumeral dislocations were treated with our manual reduction, including 71 males and 110 females, ranging in age from 19 to 94 years old, with a mean age of(61.1±16.3) years old; 68 cases of subglenoid type, 93 cases of subcoracoid type and 20 cases of subclavian type. Constant score was used to evaluate limb function while the external fixation was removed.@*RESULTS@#One hundred and fifty-seven patients achieved reduction at the first attempt and 23 patients achieved at the second time. There was no vascular damage, nerve damage or iatrogenic fracture accmpanied. The Constant score ranged from 75 to 100, with a mean score of 92.1±4.3. One hundred and sixty-eight patients were followed up, and the duration ranged from 12 to 24 months, with an average of (16.1±3.2) months, no recurrent dislocation occurred during the follow up period.@*CONCLUSIONS@#The manual reduction of WU medical school in the treatment of anterior glenohumeral dislocations has high success rate and low complication rate, which is scientific, safe, standardized, easy to learn and worth promoting.

Efficacy and Safety of Teriflunomide in Chinese Patients with Relapsing Forms of Multiple Sclerosis: A Subgroup Analysis of the Phase 3 TOWER Study / 中华医学杂志(英文版)

Background@#Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study.@*Methods@#TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54).@*Results@#Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning.@*Conclusions@#Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China.@*Trial Registration@#ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.

Comparison of over-the-scope clip and traditional through-the-scope clip in the treatment of peptic ulcer bleeding / 中国内镜杂志

Objective?To compare the difference between endoscopic hemostasis with over-the-scope clip and conventional endoscopic hemostasis with through-the-scope clip for treatment of peptic ulcer bleeding.?Methods?Using the method of retrospective study, 22 cases of peptic ulcer bleeding patients treated by endoscopic hemostasis with over-the-scope clip and 24 cases recently completed by endoscopic hemostasis with through-the-scope clip before the application of endoscopic hemostasis with over-the-scope clip as the research object, then evaluate the efficacy and safety of endoscopic hemostasis with over-the-scope clip by comparing immediate hemostasis success (rate), the total number of clips used for operation, first successful hemostasis (rate), postoperative recurrence (rate), hemostasis success (rate), rebleeding (rate), two endoscopic treatment (rate), permanent hemostasis (rate), complication (rate), postoperative hospital stay (d), mortality (rate).?Results?Immediate hemostasis success (rate) of peptic ulcer bleeding patients treated by endoscopic hemostasis with over-the-scope clip was 20/22 (90.9%) and the total number of clips used for operation was 22, the first successful hemostasis (rate) was 20/22 (90.9%), postoperative recurrence (rate) was 1/20 (5.0%), successful hemostasis (rate) was19/22 (86.4%), rebleeding (rate) was 1/20 (5.0%), two endoscopic treatment (rate) was 3/22 (13.6%), permanent hemostasis (rate) was 18/22 (81.8%), complications (rate) was 0/22 (0.0%), postoperative hospital stay time (d) was (8.95 ± 0.96) d, death (rate) was 0/22 (0.0%). Immediate hemostasis success (rate) of peptic ulcer bleeding patients treated by hemostasis therapy with through-the-scope clip was 13/24 (54.2%) and the total number of clips used for operation was 56, the first successful hemostasis (rate) was 13/24 (54.2%), postoperative recurrence (rate) was 0/13 (0.0%), successful hemostasis (rate) was 13/24 (54.2%), rebleeding (rate) was 0/13 (0.0%), two endoscopic treatment (rate) was 11/24 (45.8%), permanent hemostasis (rate) was 13/24 (54.2%), complications (rate) was 0/24 (0.0%), hospitalization time after operation (d) was (8.54 ± 0.53) d, death (rate) was 1/24 (4.2%). Immediate hemostasis success (rate), first successful hemostasis (rate), hemostasis success (rate), and permanent hemostasis (rate) were higher in the OTSC group than in the TTSC group. However, two endoscopic treatment (rate) was lower in the OTSC group than in the TTSC group (P < 0.05).?Conclusion?Endoscopic hemostasis with over-the-scope clip is safe and effective on the treatment of peptic ulcer bleeding,it can be used as the first choice for the treatment of complicated and refractory peptic ulcer bleeding due to rupture of blood vessel with the larger diameter or other causes.

Effects of compound planting on growth and quality of Salvia miltiorrhiza / 中国中药杂志

The effects of four kinds of different plant populations on the morphology, the dry matter accumulation, active ingredient content and antioxidant activty in vitro of Salvia miltiorrhiza were analyzed by setting up four kinds of mixed planting groups, such as S. miltiorrhiza and Cassia obtusifolia, Capsicum annuum, Perilla frutescens and Zea mays. And through the root isolation treatment, we preliminarily explored the formation mechanism of the four kinds of matching plants of the yield and quality of S. miltiorrhiza, and chose the matching plants suitable for the establishment of the compound population with S. miltiorrhiza,and provided the basis for constructing high efficiency compound planting pattern of S. miltiorrhiza. The results showed that there were significant differences in plant morphology, dry matter accumulation of root, active ingredient content and antioxidant activty in vitro of S. miltiorrhiza in different compound population mixed. The growth and yield of S. miltiorrhiza were unfavorable to the combination planting of Cassia obtusifolia, Z. mays and Salvia miltiorrhiza.The compound planting of P. frutescens and S. miltiorrhiza significantly promoted the growth of S. miltiorrhiza, but significantly reduced the quality of S. miltiorrhiza.The yield and quality of S. miltiorrhiza were significantly improved by the combination of C. annuum and S. miltiorrhiza. Therefore, among the four plants of C. obtusifolia, C. annuum, P. frutescens, and Z. mays, the P. frutescens of Solanaceae is the best matching species for the construction of compound planting group with S. miltiorrhiza.

The role of IL-22 in T cell reconstitution after thymus damage induced by ionizing radiation / 中华血液学杂志

Objective: To explore the levels of IL-22 in thymus damaged by γ-ray total body irradiation (TBI), and to study the role of IL-22 in T cell reconstitution after thymic injury induced by TBI. Methods: To induce thymic injury, mice were treated by sub-lethal TBI. Levels of intra-thymic and circulatory IL-22 were detected by using ELISA assay. Untreated mice were used as control. After receiving sub-lethal TBI, mice were intraperitoneally injected with PBS or recombinant mouse IL-22, which were marked as TBI+PBS or TBI+IL-22, respectively. Mice were monitored for counts of total thymic cells and circulatory white blood cells. Flow cytometry was applied to analyze percentages of thymic epithelial cells (TEC), thymocyte subsets and circulatory T cells. Real-time PCR assay was applied to analyze the mRNA expression levels of Foxn1, Ccl25, Aire and Dll4 in thymus. Results: ①Sub-lethal TBI treated mice expressed higher levels of intra-thymic and circulatory IL-22, compared with untreated ones (all P<0.05). ②After injection of recombinant IL-22, TBI+IL-22 mice had higher levels of intra-thymic IL-22 than TBI+PBS mice (all P<0.05). ③On day 14 after irradiation, real-time PCR assay showed that TBI+IL-22 mice had higher mRNA levels of Foxn1, Ccl25, Aire and Dll4 in thymus compared with TBI+PBS ones. Meanwhile, the TBI+IL-22 mice had higher counts of total thymic cells[(5.93±3.19)×10(6)/ml vs (1.42±0.46)×10(6)/ml, t=3.128, P=0.033] and circulatory white blood cells[(3.08±0.94)×10(6)/ml vs (1.43±0.30)×10(6)/ml, t=3.730, P=0.015] than those of TBI+PBS mice. Flow cytometry analysis indicated that TBI+IL-22 mice had higher counts of TEC and thymocytes than TBI+PBS mice on day 14 after irradiation (all P<0.05). On days 7 and 14 after irradiation, TBI+IL-22 mice had higher counts of circulatory white blood cells and T cells than TBI+PBS mice (all P<0.05). Conclusion: Sub-lethal TBI induces upregulation of intra-thymic IL-22, and injecting of recombinant IL-22 increases level of IL-22 in thymus. Injecting of recombinant IL-22 improves recovery of TEC and increases numbers of thymocyte subsets and circulatory T cell after thymic injury.

Current Challenges of Medical Safety Supervision in China and Suggestions of Improvement: Based on Health Care Quality Supervision Committee's Experience / 中国医院管理

Medical security is a prominent problem in China,and the medical safety supervision system needs to be improved.Through the analysis of the existing literature,medical supervision process,current situation and problems are analyzed,and the medical supervision system in England is comparatively analyzed,and the relationship model of British regulators is built,the internal mechanism of British medical supervision is analyzed,and finally through combining with the actual situation of China,new ideas for perfecting the medical safety supervision are put forward.

Video versus direct laryngoscopy on successful first-pass endotracheal intubation in ICU patients / 世界急诊医学杂志（英文）

BACKGROUND: Airway management in intensive care unit (ICU) patients is chalenging. The aim of this study was to compare the rate of successful first-pass intubation in the ICU by using the direct laryngoscopy (DL) and that by using the video laryngoscopy (VL). METHODS: A randomized, non-blinded trial comparing first-pass success rate of intubation between VL and DL was performed. Patients were recruited in the period from August 2014 to August 2016. All physicians working at ICU received hands-on training in the use of the video and direct laryngoscope. The primary outcome measure was the first-pass intubation success. RESULTS: A total of 163 ICU patients underwent intubation during the study period (81 patients in VL group and 82 in DL group). The rate of successful first-pass intubation was not significantly different between the VL and the DL group (67.9％ vs. 69.5％,P=0.824). Moreover, the overall intubation success and total number of attempts to achieve intubation success did not differ between the two groups. In patients with successful first-pass intubation, the median duration of the intubation procedure did not differ between the two groups. The Cormack-Lehane grades and the percentage of glottic opening score were similar, and no significant differences were found between the two groups. There were no statistical differences between the VL and the DL group in intubation complications (all P>0.05). CONCLUSION: Among ICU patients requiring intubation, there was no significant difference in the rate of successful first-pass intubation between VL and DL.