Practice and reflection on homogeneous management of medical services in multi-campus hospitals / 中华医院管理杂志

Homogeneous management of multi-campus medical care is an effective way to promote the expansion of high-quality medical resources, improve medical quality, and ensure medical safety. The Second Affiliated Hospital Zhejiang University School of Medicine actively explored an integrated and high-quality management mode to effectively improve medical service capacity, ensure medical technology and quality, and enhance hospital influence and social benefits from three dimensions: unified establishment, implementation of core elements, and unified quality and safety evaluation and monitoring. These practices had achieved good results and could provide reference for the multi-campus construction of other large public hospitals.

Guideline for the diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients (version 2023) / 中华创伤杂志

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Expert consensus on diagnosis, prevention and treatment of perioperative lower extremity vein thrombosis in orthopedic trauma patients (2022 edition) / 中华创伤杂志

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

Clinical efficacy and safety of secukinumab in the treatment of seven cases of erythrodermic psoriasis / 中华皮肤科杂志

Objective:To evaluate clinical efficacy and safety of secukinumab in the treatment of erythrodermic psoriasis.Methods:From July 2019 to August 2021, 7 patients with erythrodermic psoriasis, who received subcutaneous injection of secukinumab at a dose of 300 mg once a week from week 0 to 4 followed by every-4-week dosing in Wuhan Hospital of Integrated Traditional Chinese and Western Medicine, were collected. At weeks 0, 4, 8 and 12, the psoriasis area and severity index (PASI) was recorded, and adverse drug reactions were observed.Results:All 7 patients were treated for at least 12 weeks. After 4-week treatment, 4 patients achieved PASI50; after 12-week treatment, 5 achieved PASI75, and 2 achieved PASI90. No serious adverse drug reactions occurred. One patient developed fever during the treatment, but the body temperature returned to normal after management; another 1 developed cough and expectoration, and the symptoms were relieved after oral administration of a Chinese herbal preparation named pharyngitis mixture.Conclusion:Secukinumab is effective in the treatment of erythrodermic psoriasis, with fewer adverse reactions, which provides a new option for the treatment of erythrodermic psoriasis.

Effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with liver-kidney yin deficiency syndrome / 国际中医中药杂志

Objective:To investigate the effect of Duhuo Jisheng Decoction on early cartilage destruction markers in patients with rheumatoid arthritis with kidney-qi deficiency and cold syndrome.Methods:A total of 64 patients with rheumatoid arthritis in our hospital from March 2019 to March 2020 who met the inclusion criteria were divided into 2 groups, according to the random number table method, with 32 in each group. The control group was given conventional western medicine therapy, and the observation group was given Duhuo Jisheng decoction on the basis of the control group. Both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum CRP, IL-6, cartilage oligosaccharide protein (COMP) and β-catenin were detected by ELISA method, and adverse eventns during treatment were observed and compared. The clinical efficacy was evaluated.Results:The total effective rate was 87.5% (28/32) in the observation group and 65.6% (21/32) in the control group, and the difference between the two groups was statistically significant ( χ2=4.27, P=0.039). After treatment, the main symptoms, secondary symptoms and tongue and pulse scores of the observation group were significantly lower than those in the control group ( t=7.11, 3.11, 2.41, P<0.01 or P<0.05); serum CRP and IL-6 levels were significantly lower than those in the control group ( t=3.04, 4.56, P<0.01); serum COMP [(12.37±1.68) μg/L vs. (14.24±1.88) μg/L, t=4.20], β-catenin [(1.35±0.24) μg/L vs. (1.68±0.31) μg/L, t=4.76] levels were significantly lower than those in the control group ( P<0.01). During the treatment, the incidence of adverse events was 25.0% (8/32) in the observation group and 18.8% (6/32) in the control group, and there was no significant difference between the two groups ( χ2=0.37, P=0.546). Conclusion:The Duhuo Jisheng Decoction can help to reduce the levels of inflammatory cytokines and early cartilage destruction markers in patients with rheumatoid arthritis, and improve the clinical efficacy safely.

Acute Toxicity and Hepatotoxicity of Aqueous Extracts of Taxilli Herba from Different Hosts in Zebrafish Model / 中国实验方剂学杂志

Objective:To explore the acute toxicities and hepatotoxicities of aqueous extracts of Taxilli Herba from <italic>Morus alba</italic>， <italic>Toxicodendron</italic> <italic>trichocarpum</italic>， <italic>Camellia oleifera</italic>， <italic>Salix babylonica</italic>， <italic>Melia azedarach</italic>， and <italic>Nerium indicum</italic> against zebrafish model and the effect of different hosts on the toxicity of Taxilli Herba， hoping to provide a theoretical basis for the safe use of Taxilli Herba. Method:The normally developed AB zebrafish at 3-day post fertilization was selected for acute toxicity study. According to the results of preliminary toxicity experiments， the zebrafishes were treated with aqueous extracts of Taxilli Herba from different hosts at six doses， and their mortality was calculated 72 h later. GraphPad Prism 6.0 was used for plotting the dose-toxicity curve， followed by the calculation of their median lethal concentration （LC₅₀） and 10% lethal concentration （LC₁₀）. The gz15Tg/+（AB） liver fluorescent protein transgenic zebrafish with normal development at 4-day post fertilization was applied for the hepatotoxicity study. The zebrafishes were divided into the low-， medium-， and high-dose groups of aqueous extracts of Taxilli Herba from six hosts， the positive control （acetaminophen） group， and the blank （embryo amniotic fluid） group， and then treated with the corresponding drugs. Seventy-two hours later， the liver morphology and fluorescent area changes in zebrafish were observed. And the activities of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were detected. Result:The results of acute toxicity test demonstrated that the LC₅₀ values of water extracts of Taxilli Herba from <italic>M. alba</italic>， <italic>T.</italic> <italic>trichocarpum</italic>， <italic>C. oleifera</italic>， <italic>S. babylonica</italic>， <italic>M. azedarach</italic>， and <italic>N. indicum</italic> were 1.24， 0.94， 0.51， 0.38， 0.11， 0.09 g·L^-1， respectively， and the LC₁₀ values were 0.70， 0.60， 0.35， 0.28， 0.08， 0.07 g·L^-1， respectively. As revealed by hepatotoxicity test， compared with the blank group， the positive control group exhibited liver morphological changes， decreased fluorescent area （<italic>P</italic><0.01）， and elevated ALT and AST activities （<italic>P</italic>< 0.01）， suggesting that acetaminophen was hepatotoxic to zebrafish. However， there was no change in the liver morphology or fluorescent area of zebrafish in the low-， medium-， and high-dose groups of water extracts of Taxilli Herba from <italic>M. alba</italic>， and the ALT and AST activities were decreased. By contrast， the liver morphology and fluorescent areas in the medium- and high-dose groups of water extracts of Taxilli Herba from <italic>T.</italic> <italic>trichocarpum</italic>， <italic>C. oleifera</italic>， <italic>S. babylonica</italic>， <italic>M. azedarach</italic>， and <italic>N. indicum</italic> changed to varying degrees （<italic>P</italic><0.05， <italic>P</italic><0.01）. Besides， the activities of both ALT and AST were also enhanced. These indicated that Taxilli Herba from <italic>M. alba</italic> had no hepatotoxicity to zebrafish， while that from <italic>T.</italic> <italic>trichocarpum</italic>， <italic>C. oleifera</italic>， <italic>S. babylonica</italic>， <italic>M. azedarach</italic>， and <italic>N. indicum</italic> showed varying degrees of hepatotoxicity to zebrafish. Conclusion:The toxicity of Taxilli Herba is host-dependent. Taxilli Herba from <italic>M. alba</italic> has no hepatotoxicity， but that from the other five hosts shows varying degrees of hepatotoxicity. Standardizing the host source may be an important measure to realize the medication safety of Taxilli Herba.

Study on the mechanism of Polygoni Cuspidati Rhizoma in the treatment of rheumatoid arthritis based on network pharmacology and molecular docking / 国际中医中药杂志

Objective:To explore the molecular mechanism of Polygoni Cuspidati Rhizoma in the treatment of rheumatoid arthritis (RA). Methods:TCMSP database was uesed to screen the active ingredients of Polygoni Cuspidati Rhizoma and predict related targets. The therapeutic targets for RA were predicted by GeneCards database. By collecting the intersection of the rapeutic targets of Polygoni Cuspidati Rhizoma and RA, the therapeutic targets of Polygoni Cuspidati Rhizoma for the treatment of RA were obtained. Then Cytoscape 3.7.2 was used to construct a "drug-active ingredient-target-disease" network diagram. The therapeutic targets of Polygoni Cuspidati Rhizoma for treating RA were imported into the STRING database for protein-protein interaction analysis. The core targets of Polygoni Cuspidati Rhizoma for the treatment of RA were screened out by R language. And the DAVID online database and R language were used to perform GO molecular function enrichment analysis and KEGG pathway enrichment analysis. At last, Autodock Vina software was used for molecular docking of active ingredients and the top five targets. Results:The active ingredients of Polygoni Cuspidati Rhizoma were screened and corresponding to 203 targets. 4 424 target genes related to RA were retrieved in GeneCards database, and 139 targets of Polygoni Cuspidati Rhizoma intervening RA were obtained after intersection. Protein interaction analysis suggested that AKT1, TP53, JUN, MAPK1, RELA were the core targets. GO enrichment analysis on common targets obtained 35 molecular functions including ATP binding, zinc ion binding, and transcription factor activity, etc. KEGG enrichment analysis obtained a total of 117 signaling pathways related to Polygoni Cuspidati Rhizoma for RA, including the PI3K-Akt signaling pathway, the TNF signaling pathway, and pathways related to in cancer. Molecular docking showed that the active ingredients were better docked with AKT1, TP53, JUN, MAPK1 and RELA, and physciondiglucoside had a good binding ability with JUN. Conclusion:Based on network pharmacology and molecular docking, the mechanism of Polygoni Cuspidati Rhizoma in the treatment of RA is discussed, which provides a reference for pharmacological experiment and drug developmen of new herbal medicine.

Seroepidemiological survey of Toxoplasma gondii infections in patients with diabetes mellitus in Hangzhou City / 中国血吸虫病防治杂志

Objective To investigate the seroprevalence of Toxoplasma gondii infections among patients with diabetes mellitus in Hangzhou City. Methods A total of 337 patients with type 1 diabetes mellitus, 624 patients with type 2 diabetes mellitus and 384 patients with gestational diabetes mellitus living in Hangzhou City during the period from March 2017 through May 2020 were recruited as the study subjects, while age- and gender-matched healthy volunteers and pregnant women without gestational diabetes mellitus served as controls. Enzyme-linked immunosorbent assay (ELISA) was employed to detect serum IgG and IgM antibodies against T. gondii in patients with diabetes mellitus and controls, and the seroprevalence of anti-T. gondii antibody was compared between diabetes mellitus patients and controls. Results The overall seroprevalence of anti-T. gondii antibody (18.10% vs. 4.45%, χ2 = 31.38, P < 0.01) and the seroprevalence of anti-T. gondii IgG antibody (14.54% vs. 2.97%, χ2 = 28.28, P < 0.01) were both significantly higher in patients with type 1 diabetes mellitus than in healthy controls, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between patients and controls (3.56% vs. 1.48%, χ2 = 2.96, P > 0.05). The seroprevalence rates of serum anti-T. gondii (23.56% vs. 6.57%, χ2 = 70.37, P < 0.01) and anti-T. gondii IgG antibodies (21.15% vs. 5.45%, χ2 = 66.73, P < 0.01) were significantly higher in patients with type 2 diabetes mellitus than in healthy controls, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between patients and controls (2.40% vs. 1.12%, χ2 = 2.96, P > 0.05). In addition, the overall seroprevalence of serum anti-T. gondii antibody (26.30% vs. 19.53%, χ2 = 4.98, P < 0.05) and the seroprevalence of anti-T. gondii IgG antibody (23.70% vs. 17.71%, χ2 = 4.20, P < 0.05) were both significantly higher in patients with gestational diabetes mellitus than in pregnant women without gestational diabetes mellitus, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between pregnant women with and without gestational diabetes mellitus (2.60% vs. 1.82%, χ2 = 0.54, P > 0.05). Conclusions The patients with diabetes mellitus present a higher seroprevalence rate of anti-T. gondii antibody than controls in Hangzhou City. Screening of T. gondii infections and health education pertaining to toxoplasmosis prevention and control knowledge should be reinforced in patients with diabetes mellitus.

Influence of the “Sunshine Kitchen Project” on the standardized operation of catering industry / 上海预防医学

Objective:To analyze the unqualified rate of the observation indicaors before and after the implementation of “Sunshine Kitchen Project” in order to provide reference for improving the management of catering industry. Methods:This study included 415 catering establishments with implementation of the “Sunshine Kitchen Project” as intervention group and 210 catering establishments as control group without the implementation. By combining cohort study with case-control study， the unqualified rate of each observation indicator in intervention group and control group was analyzed. Results:After the intervention of “Sunshine Kitchen Project”， the unqualified rate of seven observation indicators related to operational behavior was significantly reduced， with an overall decrease of 12.44%. There were significant differences among the unqualified rate of large and medium-sized catering units and canteens in the intervention group （P < 0.001）. There was no statistically significant change in the unqualified rate of seven indicators in the control group （P > 0.1）. Compared with the control group before and after the intervention， the reduction of unqualified rate in the intervention group was significantly larger than that in the control group. The overall unqualified rate of the intervention group was significantly lower than that of the control group （P < 0.001）. Conclusion:The project of “Sunshine Kitchen” plays an active role in promoting the standardized operation of catering industry.

Periprostatic fat thickness measured on MRI correlates with lower urinary tract symptoms, erectile function, and benign prostatic hyperplasia progression / 亚洲男科学杂志(英文版)

This study investigated the correlation between periprostatic fat thickness (PPFT) measured on magnetic resonance imaging and lower urinary tract symptoms, erectile function, and benign prostatic hyperplasia (BPH) progression. A total of 286 treatment-naive men diagnosed with BPH in our department between March 2017 and February 2019 were included. Patients were divided into two groups according to the median value of PPFT: high (PPFT >4.35 mm) PPFT group and low (PPFT <4.35 mm) PPFT group. After the initial evaluation, all patients received a combination drug treatment of tamsulosin and finasteride for 12 months. Of the 286 enrolled patients, 244 completed the drug treatment course. Patients with high PPFT had larger prostate volume (PV; P = 0.013), higher International Prostate Symptom Score (IPSS; P = 0.008), and lower five-item version of the International Index of Erectile Function (IIEF-5) score (P = 0.002) than those with low PPFT. Both high and low PPFT groups showed significant improvements in PV, maximum flow rate, IPSS, and quality of life score and a decrease of IIEF-5 score after the combination drug treatment. The decrease of IIEF-5 score was more obvious in the high PPFT group than that in the low PPFT group. In addition, more patients in the high PPFT group underwent prostate surgery than those in the low PPFT group. Moreover, Pearson's correlation coefficient analysis indicated that PPFT was positively correlated with age, PV, and IPSS and negatively correlated with IIEF-5 score; however, body mass index was only negatively correlated with IIEF-5 score.

Chinese herbal medicine reduces mortality in patients with severe and critical Coronavirus disease 2019: a retrospective cohort study / 医学前沿

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

Application of magnetic resonance imaging-compatible incubator in cranial magnetic resonance imaging for neonates: a multicenter prospective randomized clinical trial / 中国当代儿科杂志

OBJECTIVE@#To study the safety and efficacy of magnetic resonance imaging (MRI)-compatible incubator in cranial MRI examination for neonates.@*METHODS@#A total of 120 neonates who were hospitalized in three hospitals and needed to undergo MRI examination were randomly divided into a control group and an experimental group, with 60 neonates in each group. The neonates in the experimental group were transferred with MRI-compatible incubator and underwent cranial MRI examination inside the MRI-compatible incubator, and those in the control group were transferred using a conventional neonatal transfer incubator and then underwent MRI examination outside the incubator. The two groups were compared in terms of the primary efficacy index (total examination time), secondary efficacy indices (times of examination, MRI completion rate on the first day of use), and safety indices (incidence rate of adverse events and vital signs).@*RESULTS@#There were no significant differences in total examination time, times of examination, and MRI completion rate on the first day of use between the two groups (@*CONCLUSIONS@#The use of MRI-compatible incubator does not significantly shorten the examination time of cranial MRI, but it does provide a relatively stable environment for examination with acceptable safety. There is a need for further studies with a larger population.

Protective Effect and Mechanism of Aqueous Extract of Perillae Folium on Adriamycin-induced Oxidative Injury in HK-2 Cell / 中国实验方剂学杂志

Objective: To investigate the protective effect of Perillae Folium with aqueous extract (PFAE) on some key factors of Adriamycin (ADR)-induced oxidative injury in human renal tubular epithelial cells(HK-2), including the survival rate, oxidative injury indexes and cell apoptosis,in order to define the underlying mechanism. Method: A model of ADR-induced HK-2 cells oxidative injury was established in vitro, then cell viability was detected by cell counting kit-8 (CCK-8) after intervention with positive reference N-acetylcysteine (NAC) or PFAE (5,15,45 g·L-1) at different concentrations. According to the morphological changes under microscopy, the optimum concentration of PFAE was screened out for the follow-up experiments. Then, the experiments were divided into six groups:blank group, ADR (0.05 g·L-1) group, PFAE (15 g·L-1) group, ADR+PFAE (0.05+15) g·L-1 group, NAC (0.81 g·L-1) group, and ADR+NAC (0.05+81) g·L-1 group. After that, malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity(TAC) were measured in the cell homogenate after 24 h administration. The level of reactive oxygen species (ROS) was detected by 2',7'-dichloroflurescin diacetate (DCFH-DA) fluorescence probe. Flow cytometry and TdT-mediated dUTP Nick-End Labeling (TUNEL) were used to monitor the cell apoptosis. Western blot was used to observed the expressions of mitochondrial apoptosis-associated proteins, like B lymphocyte tumor-2 gene (Bcl-2), Bcl-2 related X protein (Bax), cysteine aspartate protease-9 (Caspase-9), cysteine aspartate protease-3 (Caspase-3) and poly ADP-ribose polymerase (PARP), as well as their shear bodies. In addition, the phosphorylation protein expressions of p38 mitogen-activated protein kinase (p38 MAPK), extracellular signal-regulated kinase (ERK), c-Jun amino-terminal kinase (JNK) in mitogen-activated protein kinase (MAPK) signaling transduction pathway were detected by Western blot. Result: Compared with blank group, ADR group showed a decreased cell viability (PPPPPPPP-1. The ATC and SOD levels were increased in ADR+PFAE group and ADR+NAC group (PPConclusion: PFAE could alleviate the oxidative injury of HK-2 cells induced by ADR, and have an antioxidant effect, which inhibited cell apoptosis through mitochondrial apoptotic pathway and ERK/p38 MAPK signaling pathway.

Values of Hematological Indicators in the Screening of α-Thalassemia in Fujian Area of China / 中国实验血液学杂志

OBJECTIVE@#To analyze the genotypes and the hematological phenotypic characteristics of α-thalassemia in different areas of Fujian and to evaluate the values of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin (Hb), RBC distribution width/red blood cell (RDW/RBC) for screening α-thalassemia in this area.@*METHODS@#The Gap-PCR assay was applied for detecting 3 common deletional mutations of patients with α-thalassemia, and the reverse dot-blot (RDB) assay was adopted to detect the foci of 3 common non-deletional gene mutations.Then,the hematological parameters of individuals with α-thalassemia were analyzed. Finally, the optimal cut-off value in hematological indexes for screening α-thalassemia were determined by the ROC curve.@*RESULTS@#Altogether 16 types of gene mutations were found in 772 patients with α-thalassemia. Among them, the -SEA/αα deletion mutation was the most common which was observed in 521 cases(67.49%). Compared with the control group, the differences in MCV, MCH, and Hb were statistically significant between the patients of the same sex but no same type. In male groups, the RDW/RBC ratio was statistically significant in individuals of light type and HbH disease as compared with the healthy control group. But in female groups, the statistical different of RDW/RBC ratio was found between only HbH disease group and control group. MCV<81.25 fl, MCH<27.30 pg, Hb(male)<128.5 g/L, and Hb(female) <123.5 g/L, with the highest specificity and the highest sensitivity, were the best cut-off points for screening α-thalassemia in the laboratory.@*CONCLUSION@#Due to the difference of regional heterogeneity and hospital equipment environment, the different laboratories need to establish cut-off value for screening α-thalassemia suitable for its local region. In future, our laboratory can use MCV<81.25 fl, MCH<27.30 pg, Hb(male)<128.5 g/L, and Hb(female) <123.5 g/L for value for clinical screening, of α-thalassemia.

Analysis on Regularities of Recipes for IgA Nephropathy Based on Traditional Chinese Medicine Inheritance Support System / 世界科学技术-中医药现代化

Objective: To investigate the formula of traditional Chinese medicine to treat IgA nephropathy in the China National Knowledge Internet (CNKI) based on the Traditional Chinese Medicine Inheritance Support System (V2.5) .Methods: Cases of treating IgA nephropathy with Chinese herbal formulas was enrolled to establish IgA nephropathy prescriptions database and the medication rule was explored by the Traditional Chinese Medicine inheritance software.Results: There were 118 IgA nephropathy prescriptions in CNKI, including 227 traditional Chinese medicines. Among them, the commonly efficacy of traditional Chinese medicine was replenishing qi to invigorate the spleen, nourishing yin to clearing heat, promoting blood circulation and the most frequently couplet medicines was Huangqi-Fuling. The evolution resulted in 14 core combinations and 7 new prescriptions. Conclusion: The law of the medicine combination was revealed to treat IgA nephropathy in CNKI and find the novel prescriptions, and it may provide reference for clinical treatment.

Investigation on Toxoplasma gondii infection in liver disease patients in Hangzhou City / 中国血吸虫病防治杂志

Objective To understand the Toxoplasma gondii infection in liver disease patients in Hangzhou City.Methods A total of 1 200 patients with liver diseases were enrolled,including 300 patients with liver cancer,300 cases with hepatitis B,300 cases with hepatic fibrosis and 300 cases with fatty degeneration of the liver,while 1 200 healthy people served as controls.The serum anti-T.gondii IgG and IgM antibodies were detected in the subjects using ELISA assay.Results The seropositive rates of anti-T.gondii IgG and IgM antibodies were 24.00％(288/1 200)and 1.17％(14/1 200)in the liver disease patients,and 11.42％(137/1 200)and 1.08％(13/1 200)in the healthy controls,respectively.There was a significant difference in the seropositive rate of anti-T.gondii IgG antibody between the liver disease patients and controls(Χ 2=65.19,P<0.01),and no significant difference was seen in the seropositive rate of anti-T.gondii IgM antibody between the liver disease patients and con-trols(Χ 2=0.04,P>0.05).The seropositive rates of anti-T.gondii IgG antibody were 26.00％,25.00％,23.33％and 21.67％in the patients with liver cancer,hepatitis B,hepatic fibrosis and fatty degeneration of the liver,respectively,and no significant difference was detected among these patients with four types of liver diseases(Χ2=1.79,P>0.05).Conclusion The seroposi-tive rate of anti-T.gondii IgG antibody is high in liver disease patients in Hangzhou City,and the management and health educa-tion of toxoplasmosis should be given to patients with liver diseases.

A case of neuromyelitis optica spectrum disorders complicated with systemic lupus erythematosus and thymoma / 浙江大学学报·医学版

A 53-year-old male patient presented with hypopsia of his right eye for 2 months and lower extremities weakness for 8 days. Thoracic MRI demonstrated a lesion at T3 level appearing as hyperintense on T2-weighted images with non-enhancement by contrast medium and demyelinating lesion was considered. Aquaporin-4-Ab was positive and the antibody titer was 1:320 in serum. The diagnosis of neuromyelitis optica spectrum disorders was made. In addition, systemic lupus erythematosus and thymoma coexisted in this patient. After methylprednisolone impact treatment, plasma exchange and immunosuppressive therapy, the right vision and lower extremities weakness of the patient were improved.

Observation and comparison of the efficacy of three kinds of operational method for treatment of thoraco- lumbar fractures / 实用医学杂志

Objective To compare treatment and efficacy of thoracolumbar fractures by using three different screw fixations:traditional approach,the vertebral side clearance into the road and percutaneous pedicle. Methods A total of 82 single segmental thoracic lumbar fractures cases hospitalized from March 2011 to March 2014 ,with male 67 cases ,female 15 cases ,and average age(33.7+/-12.5)years old. Patients were randomly divided into three groups:traditional approach group (n = 23),operation through paraspinal muscle gap group (n = 30),percutaneous group(n = 29). These following indicators will be compared in three groups:duration of operation ,intraoperative blood loss ,intraoperative fluoroscopy time ,postoperative flow ,VAS scores before and after operation and Oswestry disability index , difference of spinal sagittal position Cobb′s Angle. Results Compared with the traditional approach group ,operation through paraspinal muscle gap group and percu-taneous group have obvious advantages in duration of operation,intraoperative blood loss,postoperative flow,VAS scores before and after operation ,the Oswestry disability index. Additionally ,above mentioned three surgical methods could recover kyphosis deformity ,and there was no statistically significant difference among three groups (P > 0.05). Conclusion In the treatment of monosegmental thoracolumbar fractures ,compared with traditional approach ,operation through paraspinal muscle gap and percutaneous pedicle screw internal fixation have more advantages which includes fewer trauma,less bleeding,faster recovery and lower incidence of postoperative low back pain.

Analysis on the depression status and its associated factors of residents in Anting Town of Shanghai / 上海预防医学

Objective To analyze the depression status and its associated factors of residents in Anting Town of Shanghai.Methods By adopting a multi-stage random sampling method, 2 500 people were selected from among the residents in Anting Town.Questionnaires were independently completed by the residents surveyed and a total of 2 498 valid questionnaires were collected.The depression module for Patient Health Questionnaire (PHQ-9) was used to evaluate depression symptoms.Univariate and multivariate logistic regression analyses were used to analyze the depression status and its associated factors.Results The detection rate of depression symptoms was 4.60% and the main symptom was light depression.Lack of vitality, eating disorders, sleep disorders and loss of enjoyment were among the most frequently-selected items in the univariate evaluation for the depression status.The results of univariate analyses indicated that age, educational level, marital status, self-evaluated health status and average(per person) family monthly income were the factors associated with the depression status.The results of multivariateanalyses indicated that self-evaluated health status and average(per person) family monthly income were the main associated factors.Conclusion The prevalence of depression status for the residents in Anting Town is relatively low.Emphases should be focused on the residents with poor health condition and with the average(per person) family monthly income below 2 000 RMB yuan.

Standardization of ambulatory surgery medical records / 中华医院管理杂志

The process of ambulatory surgery in China is faced with such challenges as the conflict between convention medical record writing requirements and time sensitiveness of ambulatory surgery, difficulty to fully take care of key points of ambulatory surgery and sufficient doctor-patient communication, difficulty to adapt to medical insurance requirements and absence of medical record writing norms for special circumstances. In this consideration, the practices of Zhejiang province were cited for a discussion on related issues, for reference of medical institutions in their standardization of ambulatory surgery.