Construction of a personnel highland in prefecture-level hospitals / 现代医院

Professional personnel stands as not only a crucial indicator of a hospital's comprehensive strength but also the primary resource driving high-quality development.In constructing the hospital's personnel highland,Chenzhou First People's Hospital adhered to the principle of"Party exercising leadership over personnel",improved its management mechanism,and pro-posed a new policy of 20 articles for the personnel.These means intensified a clear categorization of personnel,emphasized the integrity,capability,and contribution,and established a comprehensive personnel categorization evaluation system.With these efforts,the hospital is actively constructing a personnel highland in prefecture-level hospitals to provide talent support for the high-quality development of the hospital.

Jianpi Peiyuan acupoint thread embedding therapy for perimenopausal obesity: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy and safety of Jianpi Peiyuan acupoint thread embedding therapy on perimenopausal obesity (PMO).@*METHODS@#Ninety-six patients of PMO were randomly divided into an observation group (48 cases) and a control group (48 cases). The control group received health education and lifestyle intervention. On the basis of the treatment in the control group, the observation group was treated with acupoint thread embedding at the main acupoints of Shangwan (CV 13), Zhongwan (CV 12), Xiawan (CV 10), Yinlingquan (SP 9) and Fenglong (ST 40), etc. as well as the supplementary acupoints in accordance with the syndrome differentiation, once every 2 weeks for 8 weeks (4 times in total). The indexes of obesity (body mass index [BMI], waist circumference, hip circumference and body mass), modified Kupperman score, insomnia severity index (ISI) score, self-rating anxiety scale (SAS) score, and self-rating depression scale (SDS) score of the two groups were observed before and after treatment, and the safety was evaluated.@*RESULTS@#After treatment, BMI, waist circumference, hip circumference and body mass in the two groups were lower than before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). After treatment, Kupperman, ISI and SAS scores in the observation group were lower than before treatment (P<0.05), and ISI score in the control group was lower than before treatment (P<0.05). Kupperman, ISI and SAS scores in the observation group were lower than those in the control group (P<0.05). There was no significant difference in SDS between the two groups or within groups (P>0.05). No serious adverse reactions occurred during the experiment.@*CONCLUSION@#Jianpi Peiyuan acupoint thread embedding therapy can reduce the degree of obesity in PMO patients, and improve patients' the perimenopausal symptoms, insomnia and anxiety, with good safety.

Effect of acupuncture at Weizhong (BL 40) on bladder urination function based on ultrasound / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture at Weizhong (BL 40) with deqi on bladder urination function.@*METHODS@#A total of 60 healthy subjects were randomized into an observation group and a control group, 30 subjects in each group. Under the guidance of ultrasound, acupuncture was applied Weizhong (BL 40) on both sides. In the observation group, the needling depth was reached to the tibial nerve, and lifting-thrusting twirling method was used to induce deqi. In the control group, the needling depth was reached to the superficial fascia, and no manipulation was operated to induce deqi. The needles were retained for 10 min and acupuncture was given once in both groups. The bilateral ureteral ejection frequency and volume of the bladder were observed by ultrasound before and after acupuncture, and the score of clinical evaluation scale of deqi sensation was observed in both groups.@*RESULTS@#After acupuncture, the frequency of bilateral ureteral ejection in the observation group and the bladder volume in the two groups were increased compared before acupuncture (P<0.05), and the frequency of bilateral ureteral ejection, bladder volume and score of clinical evaluation scale of deqi sensation in the observation group were higher than those in the control group (P<0.05, P<0.01).@*CONCLUSION@#Acupuncture at Weizhong (BL 40) with deqi improves the bladder urination function. Ultrasound visualization improves the standardization and safety of acupuncture, intuitively evaluates the acupuncture effect, and provides an objective basis for the correlation between meridian points specificity and zang-fu organs.

Postoperative subacute static progressive stretch does not increase the risk of distal lower limb venous thromboembolism / 中华创伤杂志(英文版)

PURPOSE@#Static progressive stretch (SPS) can be applied to treat chronic joint stiffness. However, the impacts of subacute application of SPS to the distal lower limbs, where deep vein thrombosis (DVT) is common, on venous thromboembolism remain unclear. This study aims to explore the risk of venous thromboembolism events following subacute application of SPS.@*METHODS@#A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022. Patients with unilateral lower limb comminuted para-articular fractures, transferred to rehabilitation ward for further treatment within 3 weeks after operation, followed up more than 12 weeks since initial manual physiotherapy, and diagnosed DVT by ultrasound before rehabilitation course were included in the study. Patients with polytrauma, without evidence of previous peripheral vascular disease or incompetence, had medication for thrombosis treatment or prophylaxis before the operation, detected with paralysis due to nervous system impairment, infected after operation during the regime, or with acute progression of DVT were excluded. The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation. Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups. SSPS 28.0 and GraphPad Prism 9 were used for data processing. A p < 0.05 was set significant difference.@*RESULTS@#In total of 154 patients with DVT participating in this study, 75 of them were treated with additional SPS for postoperative rehabilitation. The participants in the SPS group showed improved range of motion (12.3° ± 6.7°). However, in the SPS group, there was no difference in thrombosis volume between the start and termination (p = 0.106, p = 0.787, respectively), although difference was seen intra-therapy (p < 0.001). Contingency analysis revealed the pulmonary embolism incidence (OR = 0.703) in the SPS group compared to the mean physiotherapy.@*CONCLUSION@#The SPS technique is a safe and reliable option to prevent potential joint stiffness without aggravating the risk of distal DVT for postoperative patients suffering from relevant trauma.

Vinegar-processed Euphorbiae Pekinensis Radix improves intestinal flora disorder and reduces colon toxicity / 中国中药杂志

The present study investigated the effect of Euphorbiae Pekinensis Radix(EPR) on intestinal flora structure before and after vinegar processing and explored the detoxification mechanism of vinegar-processed EPR. In this study, the extraction efficiency of casbane diterpenes from EPR with different solvents was investigated, and the optimal solvent was selected to enrich these components. After 14 days of intragastric administration of total diterpene extract of EPR and vinegar-processed EPR, 16 S rDNA sequencing technology was used to detect the structural changes of intestinal flora. The flora related to the intestinal toxicity of EPR was screened out based on the results of intestinal pathological damage by correlation analysis. The results showed that Soxhlet extraction with chloroform as extraction solvent could enrich Casbane diterpenes in EPR. As revealed by 16 S rDNA sequencing results, EPR could significantly change the structure of intestinal flora, which could be reversed by vinegar-processing EPR. Some intestinal flora candidates might be related to detoxification of vinegar processing. The correlation analysis of intestinal flora candidates and indexes related to intestinal mucosal injury showed that compared with EPR, vinegar-processed EPR could down-regulate the abundance of some pathogenic bacteria such as Mucispirillum, Bilophila, and Ruminiclostridium, and up-regulated some probiotics such as Enterorhabdus, Ruminococcaceae_UCG-014, Barnesiella, and Candidatus. The intestinal toxicity caused by EPR may be related to the disturbance of intestinal flora, and vinegar-processed EPR can improve intestinal flora disorder by up-regulating the abundance of probiotics and down-regulating the abundance of pathogenic bacteria to remodel the intestinal mucosal barrier and reduce toxicity.

Ecology and Quality Suitability Regionalization of Sabia parviflora / 中国实验方剂学杂志

Objective:To explore the potential suitable distribution area and the high-quality distribution area of <italic>Sabia parviflora</italic>. Method:Combined with the distribution information and environmental factors，the maximum entropy （MaxEnt） model and ArcGIS software were used to predict the potential suitable distribution area of <italic>S. parviflora</italic>. Based on the correlation between environmental factors and total saponins，total flavonoids，quercetin-3-<italic>O</italic>-gentiobioside，camellianoside，tsubakioside A，kaempferol-3-<italic>O</italic>-rutinoside and isobariclisin-3-<italic>O</italic>-rutinoside，the quality regionalization was conducted by using spatial interpolation method and fuzzy superposition function in ArcGIS software. Result:<italic>S. parviflora</italic> is mainly distributed in Yunnan，Guizhou，Guangxi province in China. The medium and high suitable areas accounts for about 2.88% of the national area. The precipitation in October and November，the precipitation in the warmest and driest seasons，the standard deviation of seasonal changes in temperature and altitude are the main environmental factors that affect the distribution of <italic>S. parviflora</italic>. Slope，precipitation，solar radiation and temperature change had great influence on the accumulation of secondary metabolites. Based on the results of potential suitable distribution and spatial interpolation of each component，the high-quality areas of <italic>S. parviflora</italic> are mainly concentrated in the southwest of Guizhou，with Qinglong，Guanling，Zhenning，Pu'an，Xingren county and other areas as the core. Conclusion:This study provides a scientific guidance for the site selection of artificial planting and the procurement of medicinal materials for <italic>S. parviflora</italic>.

Current status and influencing factors of readiness for hospital discharge of patients with coronary heart disease after percutaneous coronary intervention / 中国实用护理杂志

Objective:To investigate the status quo of readiness for hospital discharge of patients with coronary heart disease after percutaneous coronary intervention(PCI)and analyze the main factors affecting readiness for hospital discharge.Methods:With a cross-sectional survey method, a total of 343 patients with coronary heart disease after PCI in the Affiliated Hospital of Southwest Medical University were selected by convenience sampling method and investigated by General Information Questionnaire, Readiness for Hospital Discharge Scale, Care Transitions Measure and Self-Efficacy Questionnaire of coronary heart disease. Multiple linear regression analysis was used to analyze the influence factors.Results:The total score of Readiness for Hospital Discharge Scale of patients with coronary heart disease after PCI was 94.33±8.67. The score of quality of care transitions was 47.59±5.51 and that of self-efficacy was 39.19±8.08. Multiple linear regression analysis showed that five variables including self-efficacy, length of hospital stay, marital status, residence and family history of coronary heart disease entered into the regression equation ( P<0.01), which could explain 50.0% of the variations of readiness for hospital discharge. Conclusions:The readiness for hospital discharge of patients with coronary heart disease after PCI is at the middle level. The main influencing factors are self-efficacy, length of hospital stay, marital status,residence and family history of coronary heart disease. Nurses should attach importance to the self-efficacy of patients and pay attention to high-risk groups. By improving patients′ self-efficacy and giving targeted guidance ahead, in order to improve patients′ perception of readiness for hospital discharge.

Effects of the pestle needle therapy, a type of acupoint stimulation, on post-hemorrhoidectomy pain: A randomized controlled trial / 中西医结合学报

BACKGROUND@#Hemorrhoids are one of the most common conditions that lead to surgery, and until now surgical hemorrhoidectomy has been the major effective treatment. Post-operative pain from hemorrhoidectomy has been experienced by thousands of patients and remains a major inconvenience of the operation.@*OBJECTIVE@#This study evaluates the clinical efficacy of the pestle needle therapy, an acupoint stimulation method, for relief of post-hemorrhoidectomy pain.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#This was a single-center, patient-assessor-blinded and randomized controlled trial with 154 patients receiving Milligan hemorrhoidectomy surgery. Eligible patients were randomly assigned to either a treatment group or a control group at a ratio of 1:1. The treatment group received the pestle needle therapy, with manual stimulation at Yaoshu (DU2), Mingmen (DU4), Changqiang (DU1), Chengshan (BL57), Erbai (EX-UE2) and the perianal points (1, 3, 5, 7, 9, and 11o'clock around the lesion); while the control group received a sham treatment with very light pressure. Three sessions of treatment were performed at 30 min, 4 h and 12 h after the surgery, and each lasted for 15 min.@*MAIN OUTCOME MEASURES@#The primary outcome was post-operative pain measured with the visual analogue scale (VAS) at 12 h after surgery. The secondary outcomes included the VAS scores measured at 0.5, 2, 4, 6, 8, 24 and 48 h after surgery, the analgesic dose, the time and the VAS score of the patients' first defecation after surgery, as well as the Hamilton Rating Scale for Anxiety (HAMA) evaluated before discharge.@*RESULTS@#The mean pain score of the treatment group was significantly lower than that of the control group (3.10 ± 1.27 vs 4.82 ± 1.29; P < 0.001) at 12 h after surgery. Compared with the control group, patients in the treatment group needed a smaller dose of analgesic within the first 24 hours after surgery (P = 0.002); and their HAMA scores before discharge were lower (4.07 ± 2.40 vs 5.10 ± 2.45, P = 0.009). Compared to the treatment group, patients in the control group had a greater time to the first defecation after surgery ([52.34 ± 15.72] h vs [27.08 ± 13.68] h; P < 0.001), but there was no difference in their VAS scores at the first defecation (P = 0.092).@*CONCLUSION@#The pestle needle therapy was effective for relieving pain, reducing anxiety and improving bowel function after hemorrhoidectomy, and it is worthy of clinical application.

MAFLD vs. NAFLD: shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy / 中华医学杂志(英文版)

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, placing an increasing burden on human health. NAFLD is a complex multifactorial disease involving genetic, metabolic, and environmental factors. It is closely associated with metabolic syndrome, obesity, and type 2 diabetes, of which insulin resistance is the main pathophysiological mechanism. Over the past few decades, investigation of the pathogenesis, diagnosis, and treatments has revealed different aspects of NAFLD, challenging the accuracy of definition and therapeutic strategy for the clinical practice. Recently, experts reach a consensus that NAFLD does not reflect the current knowledge, and metabolic (dysfunction) associated fatty liver disease (MAFLD) is suggested as a more appropriate term. The new definition puts increased emphasis on the important role of metabolic dysfunction in it. Herein, the shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy of the newly defined MAFLD, as compared with the formerly defined NAFLD, are reviewed for updating our understanding.

Effect of electroacupuncture on SIRT1/NF-κB signaling pathway in adipose tissue of obese rats / 中国针灸

OBJECTIVE@#To explore the effect of electroacupuncture (EA) on insulin sensitivity, adipose tissue inflammatory reaction and silent information regulation factor 1(SIRT1)/nuclear factor kappa B (NF-κB) signaling pathway in obese rats.@*METHODS@#A total of 100 SPF-grade Wistar male rats were collected. Thirteen rats of them were selected randomly as the normal group and fed with common forage, and the rest rats were fed with high-fat forage. Eight weeks later, 39 rats that met the obesity criteria were randomized into a model group, an EA group and a sham-EA group, 13 rats in each one. In each group, 3 rats were collected randomly and the hyperinsulinemic-euglycemic clamp was exerted to record glucose infusion rate (GIR) so as to determine insulin sensitivity. Afterwards, in the EA group, EA was applied to "Zusanli" (ST 36), "Fenglong" (ST 40), "Zhongwan" (CV 12) and "Guanyuan" (CV 4), stimulated with continuous wave, 2 Hz in frequency, 1 mA in current intensity, for 15 min. The treatment was given once every 2 days, 3 times a week, for 8 weeks totally. In the sham-EA group, the needles were inserted shallowly at the sites, 5 mm lateral to each of the acupoints stimulated in the EA group, and the electrodes were attached to the needle handles, but without electric stimulation exerted. The rest management was the same as the EA group. Before and after intervention, the body mass and the insulin sensitivity were measured. After intervention, the white adipose tissue was collected from the kidney in the rats. Western blot was adopted to detect the relative protein expressions of SIRT1, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and acetylated NF-κB (Ac-NFκB). The real-time fluorescence quantitative PCR was used to detect the mRNA expressions of SIRT1, IL-6 and TNF-α. The immunofluorescence double labeling method was applied to detect the co-expression of SIRT1 and Ac-NFκB in adipose tissue.@*RESULTS@#After fed with high-fat forage for 8 weeks, the body mass was significantly increased and GIR decreased in the rats of the model group as compared with the normal group (0.05). Compared with the normal group, in the model group, the protein and mRNA expressions of SIRT1 in adipose tissue were decreased, and the protein expression of Ac-NFκB increased, the protein and mRNA expressions of IL-6 and TNF-α increased (0.05). The results of immunofluorescence double labeling showed that SIRT1 and Ac-NFκB were co-expressed in adipose tissue.@*CONCLUSION@#Electroacupuncture significantly reduces the body mass, inflammatory reaction conditions of adipose tissue and improves insulin sensitivity in obese rats. Regarding the potential mechanism, after the activation of SIRT1/NF-κB signaling pathway by electroacupuncture, and down-regulates the transcription of downstream inflammatory factors.

Research Progress of Laportea bulbifera / 中国实验方剂学杂志

The research literature of Laportea bulbifera was summarized and analyzed, and its distribution of literature, chemical composition, pharmacological activity, quality control, clinical application and patent approval were summarized, this study can provide reference for the follow-up clinical application and development and utilization of the herb. Taking CNKI and PubMed database as the retrieval platform, keywords and full text as the search items, the Honghema, Honghuoma, Zhuya Aima, Laportea bulbifera (Siebold & Zuccarini) Weddell. and Laportea bulbifera as the search terms, the domestic and foreign paper reports and patent approvals of L. bulbifera from 1989 to 2018 were retrieved. A total of 41 papers and 63 patents were reviewed, the contents of these papers were pharmacological activity, chemical composition and quality control research, the majority of patents were compound. At present, 73 chemical constituents have been isolated and identified from L. bulbifera, and most of them were flavonoids. Flavonoids, catechins and coumarins were selected as the quality control indexes, and most of the pharmacological activities were anti-inflammatory, analgesic and anti-rheumatism. L. bulbifera is highly competitive in the market because of its remarkable pharmacological activities, however, its quality control level in local standard is low and testing items are incomplete. The determination reported in the literature lacks specific indexes to evaluate the quality of L. bulbifera, at the same time, it is necessary to further study its anti-inflammatory mechanism, explore its quality markers and establish the spectrum-effect relationship, so as to effectively control the quality of L. bulbifera and provide documentation for its comprehensive utilization and resource development.

Fingerprint of Epimedium wushanense Based on Principal Component，Factor and Cluster Analysis / 中国实验方剂学杂志

Objective: To establish the fingerprint of Epimedium wushanense by HPLC,and study the comprehensive quality of E. wushanense by combining principal components,factors and cluster analysis,so as to provide theoretical basis for its quality evaluation. Method: The chromatographic column was Agilent infinitylab poroshell 120 SB-C18 (3.0 mm×100 mm,2.7 μm),the flow phase was acetonitrile (A)-water (B) with a gradient of 0-5 min,25%-26%A;5-6 min,26%-34%A;6-11 min,34%-38.5%A;11-17 min,38.5%-100%A;17-20 min,100%A,the flow rate was 0.8 mL·min- 1,the detection wavelength was 270 nm,and the column temperature was 30℃. Result: The cluster analysis better classified E. wushanense from different producing areas. E. wushanense from Guizhou province and E. wushanense from Chongqing were classified as class Ⅱ. E. wushanense from Guizhou province and Chongqing were far apart, indicating that the quality of E. wushanense varies from place to place affected by environment and climate. The results of principal component analysis showed that the quality of E. wushanense produced in Chongqing was better than that of E. wushanense produced in Guizhou. Among them,CQWS-02 (Yaque village,Guanyang town,Wushan county,Chongqing) and CQWS-10 (Hewan, Guanyang town,Wushan county,Chongqing) can be considered in the selection of high-quality varieties. In addition,No.1 common peak (epimedin A),No.2 common peak (epimedin B),No.4 common peak (icariin) and No.5 common peak (unknown component) in the fingerprint of the test samples could be used as the evaluation index components of E. wushanense quality. Conclusion: Principal components,factors and cluster analysis are used to achieve the rapid analysis, and their respective advantages are brought into full play for mutual verification and supplement. And the quality of E. wushanense in different origins can be comprehensively evaluated in all-round ways.

acupuncture method for mild cognitive impairment: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of acupuncture method for mild cognitive impairment in the elderly.@*METHODS@#A total of 96 patients were randomly divided into an observation group, a control group and a waiting group, 32 cases in each group. The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Yintang (GV 29) and Sishencong (EX-HN 1), etc, while the patients in the control group were treated with nonpenetrating sham acupuncture at the same acupoints as the observation group. The treatment was given once every other day, three times a week for 8 weeks. The patients in the waiting group only received health guidance for 8 weeks. Montreal cognitive assessment scale (MoCA) and mini-mental state examination (MMSE) were used before and after 8-week treatment in all three groups. The observation group and the control group were followed up for 2 months and evaluated with MoCA and MMSE.@*RESULTS@#The MoCA scores in the observation group after treatment and during follow-up were higher than before treatment (0.05). The MoCA scores in the control group after treatment and during follow-up were higher than before treatment (0.05). The difference before and after treatment in the observation group was higher than the control group and waiting group (0.05). The MMSE scores after treatment and during follow-up were higher than before treatment in the control group (0.05). The difference before and after treatment the observation group and control group was not significant (>0.05), and those in the two groups were higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the difference between follow-up and after treatment was lower than the control group (<0.01).@*CONCLUSION@# acupuncture method could improve cognitive impairment in elderly patients with mild cognitive impairment.

Study on HPLC fingerprint of Sabia parviflora / 中国中药杂志

This research was performed to establish the HPLC fingerprint of Sabia parviflora. HPLC method was carried out on a Thermo Accucore-C18(4. 6 mm×150 mm,2. 6 μm) column by 30% tetrahydrofuran in methyl alcohol-acetonitrile-0. 1% phosphate solution as mobile phase at a flow rate of 1. 0 m L·min-1,the column temperature was 30 ℃ and the detection wavelength was 360 nm. The fingerprints were further evaluated by chemometrics methods including similarity analysis,hierarchical clustering analysis,and principal component analysis. In HPLC fingerprint,15 common peaks were selected as the common peaks,and 6 contents of them were identified. The similarity degrees of 38 batches of the samples was more than 0. 710,and the samples were divided into 6 clusters by their quality difference. The method was precision,repeatable,stable,simple and reliable,which could be used for quality control and evaluation of S. parviflora.

Effect of EP4 gene silencing on the growth and migration of papillary thyroid carcinoma K1 cells / 实用医学杂志

Objective To investigate the effect of EP4 gene silencing on the growth and migration of K1 cells. Methods K1 cells with stable knockdown of EP4 were constructed with lentiviral vector. QRT-PCR and western blot analysis were used to detect the expression of EP4 mRNA and protein in K1 cells. CCK8 assay and flow cytometry were employed to measure cell viability and apoptosis. Transwell assay was applied to detect cell migration. Results Compared with the negative control group,the mRNA and protein expression of EP4 were sig-nificantly decreased in K1 cells with stable knockdown of EP4. Furthermore,shRNA-mediated silencing of EP4 gene remarkably suppressed cell viability and induced apoptosis of K1 cells.The migration of K1 cells with knock-down of EP4 was decreased compared with the negative control group. Conclusions EP4 gene silencing can in-hibit growth and induce apoptosis of K1 cells.Downregulation of EP4 can significantly reduce migration of K1 cells.

Comparision of the treatment and short-term and one-year prognosis from acute heart failure in tertiary hospitals versus secondary hospitals-findings from Beijing Acute Heart Failure Registry (Beijing AHF Registry) / 中华急诊医学杂志

Objective To assess and compare the incidence,clinical characteristics,treatment,and prognosis of acute heart failure patients from different grades hospitals in Beijing.Methods In this prospective internet prognosis registered study (Beijing AHF Registry),a total of 3 335 consecutive patients admitted to 14 emergency departments in Beijing from January 1st 2011 to September 23rd 2012 were enrolled.According to hospital grade,these patients were divided into two groups,349 patients were from secondary hospitals,and 2 956 patients were from tertiary hospitals.Results Among the 3 335 patients,the medium age was 71 (58,79) years,and male accounted for 53.16％.The most common underlying disease were coronary disease (43.27％),hypertension (17.73％),cardiomyopathy (16.07％) etc.The average treatment time in Emergency Department was 66.82 h.The emergency department mortality rate was 3.81％ (127 cases).The 30-day and 1-year cumulative all-cause mortality were 15.3％ and 32.27％,respectively.The 30-day and 1-year cumulative all-cause readmission were 15.64％ and 46.89％,respectively.Compared with patients in tertiary hospitals,patients in secondary hospitals had more onset acute heart failure patients (63.64％ vs.49.93％),shorter emergency department treatment time (12 h vs.41 h),lower discharge rate (3.43％ vs.37.45％) and emergency department mortality(1.58％ vs.4.09％).Compared with those in tertiary hospitals,1-year cumulative all-cause mortality (25.6％ vs.33.2％),cardiovascular disease mortality (20.2％ vs.26.0％),aggravated heart failure mortality (22.4％ vs.28.8％) were lower in secondary hospitals.Following propensity score matching,compared to tertiary hospitals,patients in secondary hospitals showed lower utilization rate of beta-blockers and ACEFARB (4.51％ vs.28.17％,1.41％ vs.9.58％),except the pironolactone.Conclusion Acute heart failure in emergency department is associated with a high mortality rate and readmission rate.There is still a big gap between guidelines recommend medication current treatments for acute heart failure.

Analysis of Curative Efficacy of Different Chemotherapy Regimen Combined with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation on Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To evaluate the efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) on patients with multiple myeloma( MM) after Sequential different chemotherapy.@*METHODS@#Seven cases of patients with MM were included in the A group, and 14 cases of patients received 4-6 courses of chemotherapy with VAD and MP before transplantation were included in the B group and received 4-6 courses of chemotherapy with VTD and VD before transplantation. Auto-peripheral blood hematopoietic stem cell were mobilized by G-CSF. Condition regimen were melphalan(A group) or bortezomib combined melphalan(B group). IFN-α(A group) or Thalidomide(B group) was used as maintenance treatment after auto-PBHSCT.@*RESULTS@#Two cases of patients reached to complete remission (CR)(2/7,28.6%),1 case got very good partial remission (VGPR) (1/7,14.3%), 4 cases got partial remission(PR) (4/7,57.1%) in A group, and 9 cases got CR (9/14,64.3%), 3 cases got VGPR(3/14,21.4%), and 2 cases got PR(2/14,14.3%) in the B group before auto-PBHSCT. The CR and VGPR were significant difference between 2 groups (P<0.05). All the patients got hematopoietic recovery. In 2 groups, the median time of ANC recovery≥0.5×10/L was 13 (11-16) and 14（11-18）days, that of WBC recovery ≥4.0×10/L were 16(15-19) and 18(16-20)days, Plt recovery ≥ 50 ×10/L was 21 (18-25) and 21(17-25) days. Bone marrow showed CR in 21 to 28 days after transplantation. All of 7 cases of patients remised in 6 to 47 months after transplantation, and 4 cases died lastly and 3 cases failed to be followed up in A group. The median time of progression-free survival(PFS) was 36(6-47) months, and that of overall survival(OS) was 37(7-50) months. In B group, 2 cases of patients remissed in 5 and 17 months after transplantation, and did lastly, 1 case relieved in 12 months after transplantation and failed to be followed up. 1 case of patient relived in 46 months after transplantation, and then received the second auto-PBHSCT, and got CR for 105 months. Other 10 cases got CR, their median time of PFS was 45.5(4-105) months, the median time of overall survival(OS) was 45.5(4-105) months. The PFS and OS were very significant different between 2 groups (P<0.01).@*CONCLUSION@#Bortezomib-based chemotherapy, Auto-PBHSCT and maintenance treatment with thalidomide were favorable to the patients of MM for survival prolongation.

Clinical Observation of Jie Yu Tong Fu Needling for Depression Coupled with Constipation / 上海针灸杂志

Objective To observe the clinical efficacy of Jie Yu Tong Fu (anti-depression and unblocking Fu-organs) needling in treating depression coupled with constipation. Method Sixty-four eligible patients with depression accompanied by constipation were recruited and randomized into a treatment group and a control group at 1:1. Each group had 2 dropout cases, and finally there were 30 complete cases in each group. The treatment group was intervened by Jie Yu Tong Fu needling by selecting Baihui (GV20), Yintang (GV29), Shenmen (HT7), Neiguan (PC6), Hegu (LI4), Sanyinjiao (SP6), Taichong (LR3), Tianshu (ST25), Zusanli (ST36) and Shangjuxu (ST37); the control group was intervened by sham acupuncture. The two groups were treated 3 times a week, for successive 8 weeks, 24 sessions in total. The two groups were evaluated by adopting Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Patient Assessment of Constipation-Symptoms (PAC-SYM) before the intervention, after 4-week and 8-week intervention, and 4 weeks after the whole intervention. Result Before the intervention, there were no significant between-group differences in the scores of HMAD, HAMA and PAC-SYM (P>0.05). The treatment group showed significant improvements in HAMD, HAMA and PAC-SYM scores after 4-week and 8-week treatment, as well as in the 4-week follow-up study compared to the scores before the treatment, and the improvements were more significant than those in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the treatment group, versus 66.7% in the control group. Conclusion Jie Yu Tong Fu needling can effectively ameliorate the depression and anxiety state and constipation-related symptoms in depression patients.

Efficacy of heated humidified high-flow nasal cannula as initial treatment for preterm infants with respiratory distress: a meta-analysis / 中华围产医学杂志

Objective To investigate the efficacy of heated humidified high-flow nasal cannula (HHHFNC) as the primary means of respiratory support for preterm infants with mild or moderate respiratory distress syndrome (RDS).Methods Randomized controlled trials (RCTs) about HHHFNC and/or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS were searched in PubMed,EMBASE,Cochrane library,Chinese Journal Full-text Database (CJFD),Wanfang Data base,VIP Database and China Biology Medicine disc (CBM).Meta-analysis was conducted with Review Manager 5.2 software to compare HHHFNC and CPAP groups in the outcomes ofpreterm infants with RDS,which included initial support failure,nasal trauma,pre-discharge mortality and incidences of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA) before discharge.Results Eight randomized trials,including 1 400 preterm infants with RDS were included.Results of the meta-analysis demonstrated that no significant difference in the percentage of initial support failure was observed between the two groups (RR=1.22,95％CI:0.94-1.59,P=0.13),and HHHFNC was associated with decreased risk for nasal trauma (RR=0.35,95％CI:0.24-0.52,P＜0.001).There was no significant difference in the incidence of death,BPD,PDA or gas leaking before discharge between the two groups.Conclusions HHHFNC is an efficient respiratory support for preterm infants (gestational age over 28 weeks) with mild or moderate RDS.

Clinical observation and nursing on ritodrine hydrochloride for the treatment of premature / 中国生化药物杂志

Objective To study clinical observation and nursing on ritodrine hydrochloride for the treatment of premature. Methods 92 pregnant women with threatened preterm labor in our hospital (February 2016 to December 2017) were randomly divided into the control group and the experimental group,each with 46 cases. The control group were treated with Magnesium Sulfate, the experimental group were treated with ritodrine hydrochloride. The experimental group and the control group were given reasonable nursing measures, and the relative clinical indexes of the two groups were compared and analyzed. Results After the corresponding treatment, the duration of pregnancy in the experimental group was (16.20±12.00) days, and the body weight of the newborn was (2.93±0.35) kg, which was significantly better than that of the control group, with statistical significance(P<0.05). Two groups of patients did not have obvious adverse reactions, nausea, vomiting, headache and other adverse reactions were 10.00% and 12.00% respectively, and there was no statistical significance. The effective rate of the experimental group was 91.30%, which was significantly higher than that of the control group (65.20%), which was statistically significant (P<0.05). Conclusion Clinical curative effect of ritodrine hydrochloride for treatment of preterm birth is ideal, can significantly improve patients' clinical symptoms, high safety.