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Danggui Sinitang is first recorded in the Treatise on Cold Damage written by ZHANG Zhongjing in the Han dynasty. It is composed of Angelicae Sinensis Radix, Cinnamomi Ramulus, Paeoniae Radix Alba, Asari Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Tetrapanacis Medulla, and Jujubae Fructus and serves as a classic formula for treating the syndrome of blood deficiency and cold reversal. This study systematically reviews the records of Danggui Sinitang in ancient Chinese medicine books of various dynasties and the modern clinical applications to probe into the composition, plant species, processing, dosage, decocting method, and indications of Danggui Sinitang, aiming to provide a reference for the development and clinical application of this classic formula. The review of the records showed that there were a variety of records of Danggui Sinitang with different composition, and the composition of this formula listed in the Treatise on Cold Damage has a significant impact on later generations and has been used by medical practitioners throughout history. Although the dosage of some drugs decreased during the Ming and Qing dynasties, the medical practitioners continued to use the original formula. In terms of processing, although there were slight changes in the processing of Angelicae Sinensis Radix, Paeoniae Radix Alba, Glycyrrhizae Radix et Rhizoma, and Tetrapanacis Medulla, the original processing method was inherited. In terms of indications, Danggui Sinitang was designed to treat cold reversal due to blood deficiency and dysentery. Furthermore, it was used to treat headache, convulsive disease, infantile convulsion, and private part adduction in the Ming and Qing dynasties. Nowadays, this formula is mostly used to treat diabetes peripheral neuropathy, rheumatoid arthritis, dysmenorrhea, Raynaud's disease and other diseases. In terms of precautions, ancient physicians believed that Danggui Sinitang should not be taken by pregnant women and should only be used for limb chills caused by blood deficiency and cold coagulation. For limb chills caused by other reasons, this formula should not be used indiscriminately. Modern research has not reported any serious adverse reactions related to this formula. Danggui Sinitang has a definite therapeutic effect. In subsequent research and development, quality control standards of Danggui Sinitang should be established while its safety is ensured, and the related preparations should be developed and applied.
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In order to provide a reference basis for the development of relevant compound preparations, this article takes a comprehensive analysis of the usage and dosage of famous classical formulas in Han dynasty from various perspectives, and gives corresponding countermeasures on this basis. Through the comprehensive analysis of the classification and statistics of Zhongjing's medication characteristics, decoction methods, administration and dosage, and combining conversion methods of weights and measures by ancient medical practitioners, along with the dosage and administration of the listed Han dynasty famous classical formulas, it was found that the "Jiangxi method" served as a general guideline for administration according to Zhongjing's original text. This method allowed for flexible dosing based on the conversion of the ancient measurements to modern equivalents[13.8 g per Liang(两)], ensuring the safe and effective medication of these formulas. After combing, it is found that although the dosage of single medicine is large in famous classical formulas from Han dynasty, the administration is flexible. The crude drug amount per administration serves as the foundational dose, with the frequency of administration adjusted flexibly according to the condition. This dosing approach becomes the key for the rational development of compound formulations of famous classical formulas. Based on the conclusions of the study, it is recommended that when developing compound formulations of famous classical formulas in Han dynasty, the original administration method and dosage should be respected. The original crude drug amount per administration should be considered as the daily foundational dose, with the frequency of administration described within a range(1 to N times per day, where N is the maximum number of administrations as per the original text). The specific frequency of administration can be adjusted flexibly by clinical practitioners based on the individual condition. This approach should also be adopted in toxicological studies, where the dosage per administration serves as the basis for toxicity research, and the toxicity profile at the maximum administration frequency should be observed, providing guidance on the clinical safety range. Corresponding drug labels should provide information within a range to indicate toxicological risk intervals.
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ObjectiveTo identify and analyze the possible influencing factors of obesity among public primary school students in Minhang District, Shanghai. MethodsBasic data, collected through questionnaire stars, was imported with merged physical examination data into Excel to form a database. Data were collected by questionnaire and analyzed by SPSS 22.00. Independent sample t-test was used for the data with normal distribution. Nonparametric test was used for the data with non-normal distribution. χ2 test was used for the quantitative data. Logistic regression was used for univariate and multivariate analysis. ResultsAccording to the national physical health standards for students (revised in 2014) , the prevalence rate of obesity among primary school students in Minhang district was 29.63% . The prevalence of overweight and obesity was 32.1% in boys and 26.9% in girls. The trend of overweight and obesity in different grades was similar among different genders .A single factor analysis showed that, being the only child (χ2=9.300, P<0.01) , father obesity(χ2=106.417, P<0.001) or mother obesity(χ2=118.534, P<0.001) , mother's overweight during pregnancy (χ2=159.731, P<0.001) , caregiver's role as grandparents (χ2=38.736, P<0.001) , low education level (χ2=111.309, P<0.001) had effects on overweight and obesity of children while the differences had statistical significance. Pupil's bad eating habit (χ2=18.905,P<0.001) and preference (χ2=22.901, P<0.001) , insufficient sleep time (χ2=61.685, P<0.001) , long-time using of electronic products (χ2=37.182, P<0.001) and low-time of exercise (χ2=15.328, P<0.001) also affected the obesity of primary school students. Among the five factors of family, diet, psychology, static state and dynamic state, the influencing factors of obesity in primary school students from grade one to grade four were being the only child, obese father and/or mother, overweight mother during pregnancy, caregivers without higher education. In terms of diet, it was mainly based on eating habits before bedtime, as well as partial and picky eating habits. In terms of psychology, the main psychological source was the pressure of learning in school. There was a clear relationship between the pace of learning and not keeping up. Static analysis revealed a correlation with lack of sleep. After assigning values based on eye hygiene recommendations for the use of electronic products, it was found that there was no direct correlation between obesity in primary school students and the duration of electronic product use. Dynamic analysis showed that not taking part in school physical exercise was related to obesity. ConclusionThe obesity of primary school students is influenced by family, diet, psychology, static and dynamic factors. The intervention of obesity in primary school needs the joint efforts of school, society, family, self-cognition and so on.
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The clinical value of Chinese patent medicine is the core direction of the development of the traditional Chinese medicine industry. The precise clinical positioning determines the way to prove the value of the drug, and is a key link to highlight the clinical value. This paper presented a case study of clinical positioning for Chinese patent medicine, namely Qizhi Tongluo capsules, and the key technical framework of precise clinical positioning of Chinese patent medicine, which was manifested as a comparison of prescription target spectral effect, discovery of core value of prescription, and confirmation of clinical positioning trial. The technical framework was designed to address a range of issues in the realm of precise clinical positioning. Before the clinical positioning trial, based on the multi-component, multi-target, and multi-phenotype data of prescription and clinical indication, the multi-omics network analysis technology was used to identify the core value of the traditional Chinese medicine varieties and predict the potential clinical advantages. Then, based on the predicted clinical advantages, reasonable efficacy indicators were selected, and the clinical efficacy was judged and verified by dynamic and flexible innovative clinical trials to improve the success rate of clinical positioning. This research paradigm integrates "omics technology" with "evidence-based" principles and follows the "precise evidence-based" concept. This research aims to provide a new strategy and method for the precise medication and positioning of Chinese patent medicine with traditional Chinese medicine characteristics after being put into the market and provide more technical thinking for traditional Chinese medicine to move towards precise medicine.
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BACKGROUND@#Craniomaxillofacial tissue defects are clinical defects involving craniomaxillofacial and oral soft and hard tissues.They are characterized by defect-shaped irregularities, bacterial and inflammatory environments, and the need for functional recovery.Conventional clinical treatments are currently unable to achieve regeneration of high-quality oral craniomaxillofacial tissue. As a natural biomaterial, silk fibroin (SF) has been widely studied in biomedicine and has broad prospects for use in tissue regeneration.Hydrogels made of SF showed excellent water retention, biocompatibility, safety and the ability to combine with other materials. @*METHODS@#To gain an in-depth understanding of the current development of SF, this article reviews the structure, preparation and application prospects in oral and craniomaxillofacial tissue regenerative medicine. It first briefly introduces the structure of SF and then summarizes the principles, advantages and disadvantages of the different cross-linking methods (physical cross-linking, chemical cross-linking and double network structure) of SF. Finally, the existing research on the use of SF in tissue engineering and the prospects of using SF with different cross-linking methods in oral and craniomaxillofacial tissue regeneration are also discussed. @*CONCLUSIONS@#This review is intended to show the advantages of SF hydrogels in tissue engineering and provides theoretical support for establishing novel and viable silk protein hydrogels for regeneration.
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The sample delivery method is one of the key steps in implementing serial femtosecond crystallography research using X-ray free-electron lasers. Serial femtosecond crystallography can effectively capture the ultrafast dynamic processes of biological molecules, such as protein conformational changes and intermediate states in chemical reactions. It is of great significance for scientists to better understand the structure and function of biological molecules, reveal the mechanisms of life activities, and provide important technical means for drug development and biotechnology. When conducting experiments at X-ray free-electron laser beamline station, it is crucial to transport the samples to the region where it interacts with the free-electron laser pulses. The choice of suitable sample delivery method plays a decisive role in the sample consumption and experimental efficiency, and it is also an important factor for the success or failure of the experiment. This article reviews the latest research progress and future development directions of sample delivery methods in serial crystallography. It also introduces commonly used sample delivery methods and their applicable ranges, aiming to provide reference and guidance for scientists engaged in serial crystallography research. The sample transport methods of free electron lasers mainly include liquid injection and fixed target sample transport. The liquid injection method is achieved through various liquid sample injectors. The aqueous solution is driven by a peristaltic pump on high performance liquid chromatography (HPLC) into a sample storage, and the aqueous solution pushes the piston in the sample storage to extrude the sample solution into the sample transport pipeline, and finally sprays it out through the nozzle to reach the XFEL interaction region. For micro-nano crystals,3 preparation methods are introduced, including free interface diffusion method, seeding method, and batch crystallization, and characterization methods are also introduced. For the requirements of high sample transmission efficiency and low sample consumption, a gas-based liquid flow transport method is introduced, which is based on the principle of focusing the sample jet by coaxial gas to form a jet with a small diameter and fast flow rate. At the same time, the extended double flow focusing nozzle and mixed injection nozzle are briefly described. For samples in viscous media, a high viscosity liquid injection device is introduced, and the advantages and disadvantages of different media are explained and exemplified. In addition, the principle and example of electrostatic spinning injector and piezoelectric driven droplet injection technology applied to low-velocity serial crystallography experiments are also introduced. For the above liquid injection methods, a characterization method using a coaxial microscope or side-view microscope to measure the diameter and stable length of the liquid flow is introduced. Compared with the liquid injection method, the fixed target method is to fix the crystal on a support chip with a periodic array structure, and collect data through scanning. The working principle, sample environment, support materials, etc. of the fixed target method are briefly introduced in the article. With the advancement and development of technologies such as free electron lasers and detectors, various sampling methods for serial crystallography are constantly being innovated and optimized. By selecting appropriate sample delivery methods, it will be possible to improve experimental efficiency, reduce sample consumption, and open up new possibilities for researchers in the field of structural biology of biomacromolecules.
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【Objective】 To identify antibody specificity in an elderly patient with hydronephrosis accompanied by ureteral stones and shock who had multiple antibodies. 【Methods】 Microcolumn gel method was used to screen unexpected antibodies of red blood cells and identify antibodies. Enzyme method and antibody absorption method were used to help judge the specificity of antibodies in patients.The ABO blood type, Rh blood type and MNS blood type of patient were determined by saline tube method. 【Results】 The patient′s blood types were O, CCDee, NNss, and a combination of anti-E, anti-c, anti-M and anti-S antibodies was detected. 【Conclusion】 Repeated blood transfusion may lead to the presence of one or more unexpected antibodies in patients. Patients with multiple or high-frequency antibodies may experience difficulties in identification and delayed blood use.
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The dosage, dose and administration method of decoctions are important factors affecting the efficacy of prescriptions. By analyzing 35 decoction formulas from the Ming and Qing dynasties within the Catalogue of Ancient Classic Famous Formulas (First Batch), it was found that the average dosage was equivalent to about 65 g, of which 71.4% (25/35) of the prescriptions had a dosage ≤60 g. And among them, the dosage of decoctions in the Ming dynasty was significantly smaller than that in the Qing dynasty. Considering the characteristics of formulas in Song dynasty, it is believed that decoctions in Ming and Qing dynasties were influenced by the popular use of decoctions during the Song, Jin, and Yuan dynasties. Some decoctions recorded a dosage of one dose instead of one day, which was more evident in the Ming dynasty. However, by the Qing dynasty, the usage of prescriptions with a dosage of one day gradually became more common. Therefore, in the practical research and application of classic famous formulas from the Ming and Qing dynasties, it is advised to pay attention to the difference between the dosage, one dose and the daily dosage. It is necessary to determine whether to double the dosage of the original formula based on the actual use, in order to ensure the clinical efficacy.
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BACKGROUND:Cell death and neuroinflammation are two important targets in the treatment of spinal cord injury.Pyroptosis is a programmed cell death closely related to neuroinflammation and targeted inhibition of pyroptosis after spinal cord injury is a promising therapeutic strategy. OBJECTIVE:To summarize the molecular mechanism,positive and negative regulatory factors and therapeutic strategies of pyroptosis in spinal cord injury. METHODS:The search terms were"spinal cord injury,pyroptosis,nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),Caspase,Gasdermin D(GSDMD),IL-1β,IL-18"and 93 English literatures included in PubMed and Web of Science were finally selected for review. RESULTS AND CONCLUSION:As a newly discovered programmed cell death,pyroptosis has been shown to play an important role in the secondary injury stage after spinal cord injury.Among the regulatory factors of pyroptosis after spinal cord injury,CD73,NRF2,GDF-11,dopamine,FANCC and miR-423-5P could inhibit pyroptosis,while TLR4 and Aopps could promote pyroptosis.In terms of treatment,the active ingredients of traditional Chinese medicine(paeonol,tripterine,betulinic acid,piperine,kaempferol,and camptothecin),exosomes of various cell origins,and some drugs(metformin,topotecan,lithium,zinc,and carbon monoxide-releasing molecule 3)can effectively inhibit pyroptosis and reduce secondary spinal cord injury,but the toxicity and specific dose of these drugs need to be further studied.The specific molecular mechanism by which pyroptosis aggravates spinal cord injury is still poorly understood.The role of non-classical pathways and other inflammasomes is worth further exploration.At present,the research on pyroptosis after spinal cord injury only stays at the animal experiment stage.There are no related clinical studies and no approved targeted therapeutic drugs.(6)The application of pyroptosis after spinal cord injury has great potential,and its specific regulatory mechanism should be further studied in the future to provide a new target for the treatment of spinal cord injury.
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Objective To conduct data mining of asthma-inducing medications in underage populations based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,so as to provide reference for the clinical application of related medications.Methods Adverse drug event(ADE)reports from the first quarter of 2013 to the fourth quarter of 2022 in the FAERS database were collected and screened for reports of asthma adverse events in the this population(under 18 years old),which were categorized into infants,toddlers,children,and adolescents according to different age groups,and were subjected to medication signal mining by using the reporting odds ratio method,the composite standardized method,and the information component method.Results A total of 1 915 reports were obtained after screening,involving 1 042(54.41%)males and 831(43.39%)females;the highest percentage of the reporting population was between 12 and under 18 years old,with a total of 762(39.79%);60.78%of the reports were reported by health professionals;and the results of the clinical referrals showed that serious adverse events occurred in 85.90%of the cases.306 suspected drugs were screened,52 drugs were determined to be valid signals,and 1 044 adverse events were reported,of which 16 drug inserts did not mention the risk of asthma,in order of elosulfatase alpha,canakinumab,tobramycin,vancomycin,ceftriaxone,cetirizine,phenylephrine,imiglucerase,cefuroxime,betamethasone,atropine,tadalafil,riscovastatin,cyclophosphamide,octreotide,and omeprazole.Conclusion The FAERS database was mined for adverse drug event signals and evaluated using the proportional disequilibrium method to identify 16 medicines that may trigger pharmacogenetic asthma and are not documented in the specification,which can be used to provide a good early warning for the clinic.At the same time,focusing on special populations,strengthening the assessment of lung function before medication and monitoring during and after medication,timely interventions were taken to reduce the harm of drug-derived adverse reactions and ensure the safe use of medication.
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Objective Based on the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database,data mining was conducted on hematological adverse events related to antibody drug conjugates(ADC),providing reference for the safe use of ADC drugs in clinical practice.Methods The report data from the third quarter of 2011 to the fourth quarter of 2022 were retrieved from the FAERS database.After data cleaning such as deduplication and name standardization,extract hematological adverse events related to ADC,and use report odds ratio method and the information component method for signal detection.Results A total of 101 610 adverse event reports were extracted,with 8 ADC drugs as the primary suspected drugs,and 5 768 ADC related hematological adverse event reports.Among them,3 423 cases of agranulocytosis were involved,and the signal intensity from strong to weak were sacituzumab govitecan(SG),gemtuzumab ozogamicin(GO),brentuximab vedotin(BV),polatuzumab vedotin(PV),enfortumab vedotin(EV),trastuzumab deruxtecan(TD),inotuzumab ozogamicin(IO)and ado-trastuzumab emtansine(TDM-1).There were 2 327 cases hematopoietic cell deficiency,with signals ranging from strong to weak were IO,SG,BV,EV,PV,TD,TDM-1,and GO.Report with clinical outcome of death of ADC drug related hematological adverse events included BV 179(16.84%),TDM-1 102(13.01%),TD 88(27.08%),GO 12(16.90%),IO 8(11.59%),EV 54(24.32%),PV 22(27.16%),and SG 84(21.05%).Adverse event time analysis showed that the number of events on the first day of TD,IO,and SG medication accounts for ≥ 40%of the total number of cases.The median time of hematological adverse events in TD,GO,IO,EV,PV,and SG was within one treatment course(21 days).Conclusion Attention should be paid to the risk of ADC drug-related hematological adverse event,during the clinical medication process,blood cell count changes should be closely monitored,and any abnormalities should be promptly diagnosed and treated.
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Objective Based on HPLC fingerprinting and chemometrics,to evaluate the quality of Schefflera kwangsiensis Merr.from Guangxi.Methods HPLC was used to establish fingerprints of Schefflera kwangsiensis Merr.from ten different origins,and gradient elution was carried out with methanol-0.1%phosphoric acid aqueous solution as mobile phase.Cluster analysis(CA),principal component analysis(PCA)and orthogonal partial least squares-discriminant analysis(OPLS-DA)were applied to evaluate quality.Results The fingerprints of Schefflera kwangsiensis Merr.from ten different origins were established by HPLC,a total of 22 common peaks were calibrated,with a similarity range of 0.922-0.999.Four chromatographic peaks were identified as rhodopsin,4,5-bis-O-caffeoylquinic acid,caffeic acid,and naringin.The samples were classified into four types according to the CA and OPLS-DA.PCA identified four principal components with a cumulative contribution rare of 95.39%.Conclusion The quality of Schefflera kwangsiensis Merr.can be comprehensively evaluated by fingerprinting combined with CA,PCA and OPLS-DA analysis.The Study can provide a reference for improving the quality control and assessment of Schefflera kwangsiensis Merr.
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Objective To understand the respiratory protection competency of staff in hospitals.Methods Staff from six hospitals of different levels and characteristics in Beijing were selected,including doctors,nurses,medical technicians,and servicers,to conduct knowledge assessment on respiratory protection competency.According to exposure risks of respiratory infectious diseases,based on actual cases and daily work scenarios,content of respira-tory protection competency assessment was designed from three aspects:identification of respiratory infectious di-seases,transmission routes and corresponding protection requirements,as well as correct selection and use of masks.The assessment included 6,6,and 8 knowledge points respectively,with 20 knowledge points in total,all of which were choice questions.For multiple-choice questions,full marks,partial marks,and no mark were given respective-ly if all options were correct,partial options were correct and without incorrect options,and partial options were correct but with incorrect options.Difficulty and discrimination analyses on question of each knowledge point was conducted based on classical test theory.Results The respiratory protection competency knowledge assessment for 326 staff members at different risk levels in 6 hospitals showed that concerning the 20 knowledge points,more than 60%participants got full marks for 6 points,while the proportion of full marks for other questions was relatively low.Less than 10%participants got full marks for the following 5 knowledge points:types of airborne diseases,types of droplet-borne diseases,conventional measures for the prevention and control of healthcare-associated infec-tion with respiratory infectious diseases,indications for wearing respirators,and indications for wearing medical protective masks.Among the 20 knowledge questions,5,1,and 14 questions were relatively easy,medium,and difficult,respectively;6,1,4,and 9 questions were with discrimination levels of ≥0.4,0.30-0.39,0.20-0.29,and ≤0.19,respectively.Conclusion There is still much room for hospital staff to improve their respiratory protection competency,especially in the recognition of diseases with different transmission routes and the indications for wearing different types of masks.
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Objective To explore the efficacy of T-cell spot test of tuberculosis infection(T-SPOT.TB)in the differential diagnosis of spinal tuberculosis(STB),and optimize diagnostic efficacy through the optimal cut-off value of receiver operating characteristic(ROC)curve.Methods Clinical data of patients with spinal infection in a hospi-tal from January 2010 to May 2019 were collected,including preoperative T-SPOT.TB test results,white blood cell count,C-reactive protein,erythrocyte sedimentation rate,procalcitonin,and tuberculosis antibodies,etal.Clinical diagnosis was conducted based on diagnostic criteria.The sensitivity and specificity of T-SPOT.TB in preoperative diagnosis of STB and other spinal infection was analyzed,and the diagnostic efficacy of the optimized T-SPOT.TB indicators was evaluated.Results A total of 132 patients were included in this study,out of whom 78 patients(59.09%)were diagnosed with STB,and 54(40.91%)were diagnosed with non-tuberculosis(non-TB)spinal in-fection.The sensitivity and specificity of T-SPOT.TB in differential diagnosis of STB were 67.68%and 66.67%,respectively.Univariate logistic regression analysis showed that compared with non-TB spinal infection,the OR va-lue of T-SPOT.TB test in diagnosing STB was 4.188(95%CI:1.847-9.974,P<0.001).The optimized T-SPOT.TB evaluation index through ROC curve to determine the optimal cut-off values of ESAT-6,CFP-10,and CFP-10+ESAT-6 for differential diagnosis of STB and non-TB spinal infection were 12.5,19.5,and 36,respec-tively,and area under curve(AUC)values were 0.765 6,0.741 5,and 0.778 6,respectively,all with good diag-nostic efficacy.CFP-10+ESAT-6 had the highest AUC.CFP-10+ESAT-6 specific spot count had higher efficacy in the diagnosis of STB,with a diagnostic accuracy of 75.56%,higher than 67.42%of pre-optimized T-SPOT.TB.Conclusion T-SPOT.TB test has high diagnostic efficacy in differentiating STB from non-TB spinal infection.Posi-tivity in T-SPOT.TB test,especially with spot count of CFP-10+ESAT-6 over 36,indicates a higher likelihood of STB.
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Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24%of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66%,85.96%,80.77%,and 74.19%,respectively.51.22%MCH institutions adopted information surveillance system on HAI cases.94.31%MCH institutions carried out surveillance on hand hygiene compliance.Over 90%MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54%MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90%MCH insti-tutions established three-level pre-examination triage systems.86.18%set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50%.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.
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Objective:To identify the risk factors for prolonged length of stay in post-anesthesia care unit (PACU-LOS) and development of a prediction model in the patients undergoing radical esophagectomy.Methods:The medical records from patients of both sexes, aged 40-80 yr, of American Society of Anesthesiologists Physical Status classificationⅠ-Ⅲ, transferred to PACU with tracheal intubation after radical esophagectomy under general anesthesia in our hospital from January 2019 to December 2020, were retrospectively collected. The patient′s age, gender, American Society of Anesthesiologists Physical Status classification, smoking history, drinking history, history of non-thoracic surgery, history of hypertension, history of diabetes mellitus, preoperative anemia, respiratory diseases, doses of anesthetics, preoperative nerve block, intraoperative consumption of opioids and dexmedetomidine, operation method (thoracotomy and endoscopic surgery), operation time, usage of vascular drugs, bradycardia, hypotension, red blood cell infusion, plasma infusion, total infusion volume, blood loss and urine volume were collected. The extubation time in PACU, visual analog scale scores at rest at 10 min after extubation, consumption of rescue analgesics in PACU, hypoxemia after extubation, and occurrence of nausea and vomiting were also collected. Patients were divided into PACU-LOS normal group (PACU-LOS≤2 h) and PACU-LOS prolonged group (PACU-LOS>2 h) according to the PACU-LOS. Logistic regression analysis was used to identity the risk factors for prolonged PACU-LOS in the patients undergoing radical esophagectomy, and the predictive model was established and verified. The receiver operating characteristic curves were used to evaluate the model discrimination and Hosmer-Lemshow goodness-of-fit test was used to evaluate the consistency of the model.Results:A total of 943 patients were included in this study, and the incidence of prolonged PACU-LOS was 15.7%. The results of logistic regression analysis showed that chronic obstructive pulmonary disease ( OR=4.900, 95% confidence interval [ CI] 2.512-9.556), increasing age ( OR=22.154, 95% CI 6.736-73.003), prolonged time of extubation ( OR=1.214, 95% CI 1.174-1.256) and hypoxemia after extubation ( OR=4.891, 95% CI 2.167-11.039) were risk factors for prolonged PACU-LOS, and the preoperative use of nerve block ( OR=0.358, 95% CI 0.190-0.672) was a protective factor for prolonged PACU-LOS in the patients undergoing radical esophagectomy ( P<0.05). The area under the receiver operating characteristic curve (95% CI) was 0.947 (0.925-0.963), the sensitivity was 0.878, and the specificity was 0.906. The internal validation of the prediction model was carried out using the receiver operating characteristic curve in the validation set, and the area under the curve (95% CI) was 0.942 (0.895-0.942, P<0.001) and the Youden index was 0.784. The line chart prediction model was developed. The prediction analysis model was verified by Hosmer-Lemshow test, P<0.001, and the C-index visualized line chart prediction model was 0.946. Conclusions:Preoperative chronic obstructive pulmonary disease, increasing age, prolonged time of extubation and hypoxemia after extubation are risk factors for prolonged PACU-LOS, and preoperative use of nerve block is a protective factor for prolonged PACU-LOS. The risk prediction model developed can effectively predict the occurrence of prolonged PACU-LOS in the patients undergoing radical esophagectomy.
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Objective:To compare the clinical efficacy and safety of water jet-assisted dermabrasion versus electric dermabrasion in combination with suction blister epidermal grafting in the treatment of vitiligo.Methods:A total of 60 vitiligo patients were enrolled from the Department of Dermatology, Xijing Hospital from March 2020 to March 2022. Thirty patients firstly received water jet-assisted dermabrasion, 30 firstly received electric dermabrasion, and then all were treated with suction blister epidermal grafting. Follow-up visits were conducted once a month, and the repigmentation of skin lesions and efficacy were evaluated and compared between the two groups 6 months after surgery.Results:There were 30 patients with 312 skin lesions in the water jet-assisted dermabrasion group, including 13 males and 17 females, with the ages and disease duration being 24.41 ± 3.12 years and 5.13 ± 2.34 years respectively; there were 30 patients with 301 skin lesions in the electric dermabrasion group, including 11 males and 19 females, with the ages and disease duration being 22.73 ± 5.11 years and 4.88 ± 2.21 years respectively. No significant differences were observed in the age, gender, disease duration, and dermabrasion sites between the two groups (all P > 0.05). Six months after the operation, 187 (59.94%) skin lesions were healed, 103 (33.01%) were markedly improved, and 22 (7.05%) were improved in the water jet-assisted dermabrasion group; in the electric dermabrasion group, 166 (55.15%) lesions were healed, 108 (35.88%) were markedly improved, and 27 (8.97%) were improved; there was no significant difference in the total response rate between the water jet-assisted dermabrasion group (92.95%) and the electric dermabrasion group (91.03%; χ2 = 0.27, P = 0.602). The water jet-assisted dermabrasion group showed significantly higher degree of repigmentation (90.47% ± 2.53%), matching degree of skin color (3.53 ± 0.21 points), and patient satisfaction scores (3.32 ± 0.27 points) compared with the electric dermabrasion group (82.40% ± 5.33%, 2.71 ± 0.32 points, 2.68 ± 0.41 points, t = 5.30, 8.28, 5.09, respectively, all P < 0.05). No adverse reactions/events were seen in either group. Conclusions:The water jet-assisted dermabrasion combined with suction blister epidermal grafting and electric dermabrasion combined with suction blister epidermal grafting showed similar efficacy in the treatment of vitiligo, with good safety profiles. However, the degree of repigmentation, matching degree of skin color, and patient satisfaction rates were all higher in the patients receiving water jet-assisted dermabrasion than those receiving electric dermabrasion.
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Atrial fibrillation and skeletal musculopenia are common diseases in elderly patients, and the two conditions share the common risk factors and pathogenesis, and interact with each other during their occurrence and development. This article reviews the research advances on the epidemiology, risk factors, pathogenesis of atrial fibrillation and sarcopenia in the elderly, as well as the screening, evaluation and comprehensive management of elderly patients with atrial fibrillation combing sarcopenia.
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SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.
El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.
Assuntos
Humanos , Criança , Postura , Vértebras Cervicais/anatomia & histologia , Cabeça/anatomia & histologia , Má Oclusão Classe III de Angle/terapia , Cefalometria , Pontos de Referência AnatômicosRESUMO
Thirteen isoflavones were separated and purified from an ethanol extract of the rhizome of Dalbergia benthamii Prain by using silica gel, Sephadex LH-20, recrystallization et al. Their structures were identified by physicochemical properties and spectral analysis such as MS, 1D/2D-NMR as dalbergibenthamin (1), butesuperin A (2), xanthocercin A (3), butesuperin B (4), di-O-methylalpinum isoflavone (5), 2′-deoxgisoaunculutin (6), robustone (7), 4′-hydroxy-5,7-dimethoxy-6-(3-methyl-2-butenyl)-isoflavone (8), formononetin (9), 6″-O-rhamnosyldaidzin (10), 3′,4′-di-O-methylene-5-hydroxy-7-methoxy-6-isopentenyl isoflavone (11), derrubone dimethyl enter (12), and derrubone (13). Compound 1 is a pair of new isoflavonoid enantiomers, compound 12 is a new natural product and compounds 1-7 and 10-13 were obtained from D. benthamii Prain for the first time. In vitro cytotoxic activities of the compounds were explored by MTS testing with HL-60, A-549, SMMC-7721, MCF-7 and SW480 cell lines. Results show that compound 8 significantly inhibited cellular proliferation. The IC50 of compound 8 in A-549 and SW480 cells was 16.68 ± 0.19 and 15.21 ± 0.60 μmol·L-1.