Case Study on Deductive Teaching of "Doctor-patient Communication" / 中国医学伦理学

By introducing the connotation of deductive teaching and analyzing the significance of early contact clinical course of "doctor-patient communication", the author reinterpreted the educational concept of deductive teaching combined with the characteristics of medical humanities, and reformed the early contact clinical course of "doctor-patient communication" by introducing deductive teaching method. Taking the early contact clinical course of "doctor-patient communication" of a medical university as an example, the teaching framework was designed to share experience from three aspects: teaching content, teaching process and teaching effect evaluation. At the same time, combined with the characteristics of the course and the needs of students, found out the problems encountered in the teaching process, and put forward constructive opinions and strategies, in order to provide theoretical and practical reference for the teaching of medical humanities course.

Clinical study on application of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions / 中华外科杂志

Objective: To examine the application value of 3D Slicer software assisted domestic frameless stereotactic robot in biopsy of intracranial lesions. Methods: A retrospective analysis was performed on 80 patients who admitted consecutively and underwent intracerebral lesions biopsy with the domestic frameless stereotactic robot at Department of Neurosurgery, Aerospace Central Hospital from January 2019 to December 2021. There were 36 males and 44 females, with a mean age of (38.5±18.0) years (range: 6 to 71 years). Before surgery only enhanced T1-weighted three-dimensional magnetization prepared gradient echo sequences and diffusion tensor imaging scans were performed. Self-reconstruction of intracranial lesions, cerebral cortex and blood vessels was carried out using 3D Slicer software system after the DICOM format imaging data of 80 patients were collected. These imaging data were merged to the workstation of the domestic frameless stereotactic robot for preoperative surgical planning and the surgical puncture path was designed to avoid blood vessels in the brain functional area, cerebral cortex and sulcus. Results: All frameless stereotactic biopsy were successfully performed. Postoperative pathological diagnosis included 50 cases of diffuse astrocytic and oligodendroglioma, 15 cases of lymphoma, 5 cases of metastatic tumors, 5 cases of inflammatory demyelinating disease, 2 cases of inflammatory granuloma, 1 case of hemangioma, 1 case of acute lymphoblastic leukemia intracranial invasion and 1 case of seminoma. The positive diagnosis rate was 100% (80/80). Postoperative imaging confirmed that the puncture path and target were accurately implemented according to the preoperative planning, and the target error was (1.32±0.44) mm (range: 0.55 to 1.99 mm). One case of puncture-related bleeding occurred at the target after surgery and improved after treatment. Conclusion: The three-dimensional multimodal images reconstructed by the 3D Slicer software before operation could help the surgeons make the preoperative planning and reduce the risk of stereotactic brain biopsy.

Mechanism of Xuebijing Injection in treatment of sepsis-associated ARDS based on network pharmacology and in vitro experiment / 中国中药杂志

The aim of this study was to investigate the effect and molecular mechanism of Xuebijing Injection in the treatment of sepsis-associated acute respiratory distress syndrome(ARDS) based on network pharmacology and in vitro experiment. The active components of Xuebijing Injection were screened and the targets were predicted by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). The targets of sepsis-associated ARDS were searched against GeneCards, DisGeNet, OMIM, and TTD. Weishengxin platform was used to map the targets of the main active components in Xuebijing Injection and the targets of sepsis-associated ARDS, and Venn diagram was established to identify the common targets. Cytoscape 3.9.1 was used to build the "drug-active components-common targets-disease" network. The common targets were imported into STRING for the building of the protein-protein interaction(PPI) network, which was then imported into Cytoscape 3.9.1 for visualization. DAVID 6.8 was used for Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment of the common targets, and then Weishe-ngxin platform was used for visualization of the enrichment results. The top 20 KEGG signaling pathways were selected and imported into Cytoscape 3.9.1 to establish the KEGG network. Finally, molecular docking and in vitro cell experiment were performed to verify the prediction results. A total of 115 active components and 217 targets of Xuebijing Injection and 360 targets of sepsis-associated ARDS were obtained, among which 63 common targets were shared by Xuebijing Injection and the disease. The core targets included interleukin-1 beta(IL-1β), IL-6, albumin(ALB), serine/threonine-protein kinase(AKT1), and vascular endothelial growth factor A(VEGFA). A total of 453 GO terms were annotated, including 361 terms of biological processes(BP), 33 terms of cellular components(CC), and 59 terms of molecular functions(MF). The terms mainly involved cellular response to lipopolysaccharide, negative regulation of apoptotic process, lipopolysaccharide-mediated signaling pathway, positive regulation of transcription from RNA polyme-rase Ⅱ promoter, response to hypoxia, and inflammatory response. The KEGG enrichment revealed 85 pathways. After diseases and generalized pathways were eliminated, hypoxia-inducible factor-1(HIF-1), tumor necrosis factor(TNF), nuclear factor-kappa B(NF-κB), Toll-like receptor, and NOD-like receptor signaling pathways were screened out. Molecular docking showed that the main active components of Xuebijing Injection had good binding activity with the core targets. The in vitro experiment confirmed that Xuebijing Injection suppressed the HIF-1, TNF, NF-κB, Toll-like receptor, and NOD-like receptor signaling pathways, inhibited cell apoptosis and reactive oxygen species generation, and down-regulated the expression of TNF-α, IL-1β, and IL-6 in cells. In conclusion, Xuebijing Injection can regulate apoptosis and response to inflammation and oxidative stress by acting on HIF-1, TNF, NF-κB, Toll-like receptor, and NOD-like receptor signaling pathways to treat sepsis-associated ARDS.

Effect of monosialotetrahexosylganglioside sodium treatment on neurological function, inflammatory factor and blood coagulation function in patients with traumatic brain injury / 中国基层医药

Objective:To investigate the effect of monosialotetrahexosylganglioside sodium treatment on neurological function, inflammatory factor, and blood coagulation function in patients with traumatic brain injury.Methods:The clinical data of 90 patients with traumatic brain injury who received treatment in Taizhou Central Hospital from February 2018 to May 2020 were retrospectively analyzed. These patients were divided into a control group ( n = 46) and an observation group ( n = 44) according to different treatment methods. The control group was given routine symptomatic treatment and the observation group was given monosialotetrahexosylganglioside sodium treatment based on routine symptomatic treatment. Remission rate, inflammatory factor level, the National Institutes of Health Stroke Scale score, Glasgow Outcome Scale score, and coagulation function were compared between the two groups at each time point. Results:At 3 days and 2 weeks post-surgery, neuropeptide Y in the observation group was (121.13 ± 12.68) ng/L and (68.52 ± 10.21) ng/L, tumor necrosis factor α was (96.15 ± 8.16) ng/L and (46.68 ± 5.95) ng/L, interleukin-6 was (231.26 ± 9.41) ng/L and (126.74 ± 12.23) ng/L, C-reactive protein was (47.52 ± 4.32) μg/L and (18.65 ± 1.32) μg/L, the National Institutes of Health Stroke Scale score was (20.12 ± 2.22) points and (17.67 ± 1.31) points. They were significantly lower than those in the control group [neuropeptide Y: (135.69 ± 15.42) ng/L, (79.36 ± 11.15) ng/L; tumor necrosis factor-α: (108.56 ± 10.13) ng/L, (69.33 ± 6.42) ng/L; interleukin-6: (264.13 ± 10.24) ng/L and (157.89 ± 12.13) ng/L; C-reactive protein: (65.19 ± 5.17) μg/L and (24.39 ± 3.45) μg/L; the National Institutes of Health Stroke Scale score: (24.56 ± 2.54) points and (20.39 ± 2.55) points] ( t3 days post-surgery = 4.88, 6.38, 15.83, 17.55, 8.81; t2 weeks post-surgery= 4.80, 17.33, 12.12, 10.33, 6.32, all P < 0.001). At 3 days and 2 weeks post-surgery, the Glasgow Outcome Scale score in the observation group was (3.65 ± 0.35) points and (4.65 ± 0.26) points, respectively, which was significantly higher than (3.15 ± 0.10) points and (4.11 ± 0.11) points in the control group ( t = 9.30, 12.93, both P < 0.05). At 3 days and 2 weeks post-surgery, fibrinogen in the observation group was (4.52 ± 0.39) g/L and (3.12 ± 0.10) g/L, thrombin time was (18.46 ± 2.95) seconds and (21.79 ± 2.45) seconds, prothrombin time was (12.42 ± 1.33) seconds and (15.79 ± 2.36) seconds, activated partial thromboplastin time was (34.59 ± 2.64) seconds and (38.98 ± 2.78) seconds, which were significantly superior to those in the control group [fibrinogen: (5.02 ± 0.13) g/L and (4.29 ± 0.16) g/L; thrombin time: (17.36 ± 1.56) seconds and (19.63 ± 1.62) seconds; prothrombin time: (10.69 ± 1.21) seconds and (13.26 ± 1.78) seconds; activated partial thromboplastin time: (32.16 ± 2.59) seconds and (35.69 ± 2.91) seconds] ( t3 days post-surgery = 8.23, 2.22, 6.46, 4.40; t2 weeks post-surgery = 41.38, 4.95, 5.75, 5.48, all P < 0.001). At 1 and 2 weeks post-surgery, the remission rate in the observation group was significantly higher than that in the control group ( χ2 = 4.75, 4.44, both P < 0.05). Conclusion:Monosialotetrahexosylganglioside sodium treatment for a traumatic brain injury can inhibit inflammatory reactions, improve blood coagulation and protect brain tissue.

Atractylenolide Ⅰ improves acetaminophen-induced acute liver injury in mice by inhibiting MAPK/NF-κB signaling pathway / 中国中药杂志

This study explored the protective effect of atractylenolide Ⅰ(AO-Ⅰ) against acetaminophen(APAP)-induced acute liver injury(ALI) in mice and its underlying mechanism. C57 BL/6 J mice were randomly divided into a control group, an APAP group(500 mg·kg~(-1)), a low-dose combination group(500 mg·kg~(-1) APAP + 60 mg·kg~(-1) AO-Ⅰ), and a high-dose combination group(500 mg·kg~(-1) APAP + 120 mg·kg~(-1) AO-Ⅰ). ALI was induced by intraperitoneal injection of APAP(500 mg·kg~(-1)). AO-Ⅰ by intragastric administration was performed 2 hours before APAP treatment, and the control group received the same dose of solvent by intragastric administration or intraperitoneal injection. The protective effect of AO-Ⅰ against APAP-induced ALI was evaluated by detecting alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels in the plasma and H&E staining in liver tissues of mice. The malondialdehyde(MDA) and glutathione(GSH) content and catalase(CAT) activity in mouse liver tissues were detected to evaluate the effect of AO-Ⅰ on APAP-induced oxidative stress in the liver. The proteins in the liver p38 mitogen-activated protein kinase(p38 MAPK), c-jun N-terminal kinase(JNK), and nuclear factor kappa-B p65(NF-κB p65) signaling pathways were measured by Western blot, and the liver inflammatory cytokines interleukin-1β(IL-1β) and interleukin-6(IL-6) were detected by real-time PCR. Compared with the APAP group, the combination groups showed reduced APAP-induced ALT level and liver MDA content, potentiated liver CAT activity, and elevated GSH content. Mechanistically, AO-Ⅰ treatment significantly inhibited APAP-up-regulated MAPK phosphorylation and NF-κB p65, and significantly reduced the transcriptional activities of IL-1β and IL-6, downstream targets of NF-κB p65. AO-Ⅰ can improve APAP-induced ALI and the underlying mechanism is related to the inhibition of the MAPK/NF-κB p65 signaling pathway in APAP-challenged mice.

The protective effect of diosmetin on liver ischemia/reperfusion in mice though anti-inflammation and antioxidation / 中国药理学通报

Aim To study the role of diosmetin ( Dio) in liver ischemia/reperfusion and its possible mecha-nism.Methods Thirty-two mice were randomly di¬vided into sham group, I/R group, low-dose Dio group and high-dose Dio group, with 8 mice in each group.The I/R group received liver I/R surgery, and the sham group performed sham surgery.The low- and high-dose Dio groups received intraperitoneal injection of 10 mg • kg ~1 and 40 mg • kg ~1 Dio at 30 min before liver I/R, respectively.Blood and liver samples were collected at 24 h after reperfusion.ELISA was used to detect the levels of interleukin ( IL)-ip, 1L-6, lactic dehydrogenase ( LDH ) and aspartate transaminase ( AST) in serum.Hie levels of malondialdehyde ( MDA ) , reactive oxygen species ( ROS) , reduced glutathione (GSH) and total bilirubin (TBIL) in liver homogenate were measured.HE staining was used to observe liver injury.Immunohistochemical staining was used to observe the expression of IL-ip in liver tis¬sues.Western blot was used to detect the expression of cleaved-c a spa se-3 , p-NF-kb p65 and p-p38 proteins in liver tissues.Results Compared with sham group, the degree of liver injury in I/R group significantly in¬creased , and the levels of 1L-1 (3, 1L-6, LDH and AST in serum, MDA, ROS and cleaved-caspase-3, p-NF- kb p65 and p-p38 proteins in liver tissues markedly in¬creased ; however, the levels of GSH and TB1L signifi¬cantly decreased, and the differences in the above in¬dexes were statistically significant.Compared with I/R group, the above indexes in low- and high-dose Dio groups were significantly improved, and the effect of high-dose group was better than that of low-dose group.Conclusions Dio pretreatment can reduce liver I/R injury, which may be related to the reduction of oxida¬tive stress and inflammation-related pathways induced by liver I/R.

Influence factors of debilitating and nutritional risk on complications of primary hip replacement / 中国骨伤

OBJECTIVE@#To analyze relationship of debilitating and nutritional risk on complications of primary hip replacement, and risk factors of influence of complications of primary hip replacement.@*METHODS@#Totally 100 patients who underwent hip replacement from January 2019 to January 2021 were retrospectively analyzed, including 36 males and 64 females, aged from 18 to 85 years old with an average of (73.82±4.04) years old. Postoperative frailty status was evaluated by modified frailty index, and nutritional status was evaluated by clinical biochemical indexes and NRS2002 nutritional risk assessment scale. One hundred patients were divided into frailty group and non-frailty group according to modified frailty index, 100 patients were divided into normal nutrition group and nutritional risk group according to nutritional status, and relationship between frailty, nutritional risk and complications after primary hip replacement was analyzed.@*RESULTS@#There were significant differences in age, body mass index (BMI), complications and ASA grade between frailty group and non-frailty group(P<0.05). There were statistically significant differences in age, BMI, complications and ASA grade between normal nutrition group and nutritional risk group (P<0.05). Thirty-five patients occurred at least one postoperative complications, and the incidence of pulmonary infection was the highest, accounting for 34.29% (12/35). The second was urinary infection, accounting for 22.86%(8/35). Univariate Logistic regression analysis showed that age, BMI, ASA grade, complications, frailty and nutritional risk were the risk factors for postoperative complications. Multivariate Logistic regression analysis showed that complications, frailty and nutritional risk were independent factors affecting postoperative complications.@*CONCLUSION@#Patients with comorbidities, frailty and nutritional risk could increase the incidence of complications. Timely assessment and identification of these patients in time, and formulation of targeted intervention measures have great clinical significance.

A Prognostic Model for Brain Glioma Patients Based on 9 Signature Glycolytic Genes.

OBJECTIVE: To screen glycolytic genes linked to the glioma prognosis and construct the prognostic model. METHODS: The relevant data of glioma were downloaded from TCGA and GTEx databases. GSEA of glycolysis-related pathways was carried out, and enriched differential genes were extracted. Screening out prognostic-related genes with conspicuous significance and construction of the prognostic model were conducted by multivariate Cox regression analysis and Lasso regression analysis. The model was evaluated, and cBioPortal was used to analyze the mutation of the model gene. The expression of the model gene in tumor and normal colon tissue was analyzed. The model was used to evaluate the prognosis of patients in different groups to verify the applicability of the model. RESULTS: 339 differentially glycolytic-related genes were enriched in REACTOME_GLYCOLYSIS, GLYCOLYTIC_PROCESS, HALLMARK_GLYCOLYSIS, and other pathways. We obtained 9 key prognostic genes and constructed the prognostic evaluation model. The 3-year AUC values of the ROC curve display model are greater than 0.75, which indicates that the accuracy of the model is good. The relation of age and risk score to prognosis is shown by univariate and multivariate Cox analysis. The expression of SRD5A3, MDH2, and B3GAT3 genes was significantly upregulated in the tumor tissues, while the HDAC4 and G6PC2 genes were downregulated. The mutation rate of MDH2 and HDAC4 genes was the highest. This model could effectively distinguish the risk of poor prognosis of patients in any age stage. CONCLUSION: The prognostic assessment models based on glycolysis-related nine-gene signature could accurately predict the prognosis of patients with GBM.

A retrospective study to compare the treatment outcomes with and without surgical navigation for fracture of the orbital wall / 中华创伤杂志(英文版)

PURPOSE@#To evaluate the outcomes with and without aid of a computer-assisted surgical navigation system (CASNS) for treatment of unilateral orbital wall fracture (OWF).@*METHODS@#Patients who came to our hospital for repairing unilateral traumatic OWF from 2014 to 2017 were included in this study. The patients were divided into the navigation group who accepted orbital wall reconstruction aided by CASNS and the conventional group. We evaluated the surgical precision in the navigation group by analyzing the difference between actual postoperative computed tomography data and preoperative virtual surgical plan through color order ratios. We also compared the duration of surgery, enophthalmos correction, restoration of orbital volumes, and improvement of clinical symptoms in both groups systemically. Quantitative data were presented as mean ± SD. Significance was determined by the two-sample t-test using SPSS Version 19.0 A p < 0.05 was considered statistically significant.@*RESULTS@#Seventy patients with unilateral OWF were included in the study cohort. The mean difference between preoperative virtual planning and actual reconstruction outcome was (0.869 ± 0.472) mm, which means the reconstruction result could match the navigation planning accurately. The mean duration of surgery in the navigation group was shorter than it is in the control group, but not significantly. Discrepancies between the reconstructed and unaffected orbital-cavity volume and eyeball projection in the navigation group were significantly less than that in the conventional group. One patient had remnant diplopia and two patients had enophthalmos after surgery in the navigation group; two patients had postoperative diplopia and four patients had postoperative enophthalmos in the conventional group.@*CONCLUSION@#Compare with the conventional treatment for OWF, the use of CASNS can provide a significantly better surgical precision, greater improvements in orbital-cavity volume and eyeball projection, and better clinical results, without increasing the duration of surgery.

[Effect of Qufu Shengji ointment(QFSJO) on promoting the healing of infectious wounds].

OBJECTIVE: To explore the clinical effect of Qufu Shengji ointment(QFSJO) in promoting the wound healing after trauma. METHODS: From January 2014 to June 2018, 60 patients with soft tissue injury, skin defect and wound infection caused by violent trauma were admitted, including 32 males and 28 females, aged from 18 to 65 years, with an average age of 41.3 years. Among them, 30 patients were treated with QFSJO (QFSJO group) and 30 patients were treated with normal saline iodophor (control group). The reduction rate of wound area, the days of decayed flesh, the time of new epithelium and the recovery rate of 28 days after dressing change were compared between the two groups. RESULTS: In the QFSJO group, after using large dose of QFSJO, the pus of the wound increased, the granulation grew, and the new epithelium appeared on the edge of the wound, showing a rapid healing phenomenon. The wound healing rate of QFSJO group was higher than that of the control group at all time points, and the time of decaying flesh and new epithelium appeared in QFSJO group was earlier than that of the control group. The recovery rate of QFSJO group was significantly higher than that of the control group(P<0.05). All the patients were followed up, and the duration ranged form 6 to 12 months, with an average of 9.4 months. The exposed areas of bone and teadon were covered well. The vital signs of the two groups were stable and no adverse reactions occurred. CONCLUSIONS: QFSJO can promote the growth of granulation tissue, promote the production of new skin, and accelerate the healing of infectious wound after trauma.

Binuclear cobalt phthalocyanine supported on manganese octahedral molecular sieve: High-efficiency catalyzer of peroxymonosulfate decomposition for degrading propranolol.

Propranolol (PRO) is widely detected in the aquatic environment and proved to be detrimental to multifarious aquatic organisms. In view of some virtues of sulfate radicals than hydroxyl radicals, advanced oxidation technologies that involve the activation of peroxymonosulfate (PMS) have stimulated wide-ranging research on the PRO removal. In this paper, a composite (C2NOMS-2) of amino-functionalized manganese octahedral molecular sieve (NOMS-2) and binuclear cobalt phthalocyanine (Co2CPc) was synthesized easily, and utilized as a catalyzer for PMS to degrade PRO in water. The apparent rate constants of PRO degradation by PMS with C2NOMS-2 as a catalyst was found to be higher than with NOMS-2, Co2CPc and the composite of uninuclear cobalt phthalocyanine (CoCPc) and NOMS-2. The catalytic ability of C2NOMS-2 was investigated under various reaction conditions: catalyst dosages (0.5-2.0 g/L), PMS doses (50-500 mg/L), initial pH (5-11), reaction temperature (20-35 °C), and natural water constituents (Cl-, HCO3-, and sodium huminate). Radical scavenging tests and electron paramagnetic resonance spectroscopy showed that 1O2 was the most critical reactive oxygen species, and conceivable mechanisms of PMS activation with C2NOMS-2 were proposed established on the curve estimation of high-resolution XPS spectra, revealing that the generation of reactive oxygen species was mainly resulted from the cycles of Mn3+/Mn4+, Co3+/Co2+ and surface lattice oxygen/surface adsorbed oxygen. The intermediate products of propranolol degradation were identified by LC-MS/MS. Cycling experiments and ion dissolution detection suggested that C2NOMS-2 could maintain satisfactory stability in an aqueous system.

MiR-129-5p enhances the radiosensitivity of thyroid myeloid cell MZ-CRC-1 by inhibiting HMGB1 / 中华放射医学与防护杂志

Objective To explore whether MiR-129-5p participates in radiosensitivity of medullary thyroid cell MZ-CRC-1 by inhibiting the gene expression of high mobility group protein B1 ( HMGB1) . Methods The radioresistant cell line MZ-CRC-1/R was established from MZ-CRC-1. Cell survival fraction was analyzed by colony formation assay. The expressions of miR-129-5p in MZ-CRC-1 and MZ-CRC-1/R cells were detected by qRT-PCR. Cell viability was determined by MTT assay. Cell apoptosis was measured by flow cytometry. Dual-luciferase reporter assay was performed to confirm the relationship between miR-129-5p and HMGB1. Besides, the protein expressions of HMGB1 and p-AKt were evaluated by western blot. Results Compared with that of MZ-CRC-1 cells, the survival fraction of MZ-CRC-1/R cells was significantly increased (t=3. 038, 4. 330, 4. 885, 4. 568, P<0. 05), the cell viability of MZ-CRC-1/R cells was also increased ( t=3. 637, 7. 734, 11. 896, 14. 522, P<0. 05) , and the expression of miR-129-5p(0.26±0.03) was significantly decreased in MZ-CRC-1/R cells(1.00±0.06) (t=19. 107, P<0. 05) . Compared with miR-NC-inhibitor group, cell viability was promoted and cell apoptosis was blocked in the miR-129-5p-inhibitor group ( t=5. 156, 6. 005, 9. 649, 8. 659, P<0. 05) . Moreover, miR-129-5p mimic suppressed cell viability and enhanced cell apoptosis after irradiation ( t=3. 118, 5. 034, 6. 005, 7. 488, 6. 362, P<0. 05) . Overexpression of miR-129-5p inhibited the protein expressions of HMGB1 and p-AKt (t=9. 325, 10. 614, P<0. 05). In addition, HMGB1 depletion rescued cell apoptosis that was reduced by miR-129-5p inhibitor in MZ-CRC-1 cells ( t=6. 700, P<0. 05) , while HMGB1 overexpression attenuated the effect of miR-129-5p upregulation on MZ-CRC-1/R cells ( t=7. 073,P<0. 05) . Conclusions miR-129-5p increased the radiosensitivity of medullary thyroid-like cell MZ-CRC-1 by inhibiting HMGB1.

Effect of Qufu Shengji ointment(QFSJO) on promoting the healing of infectious wounds / 中国骨伤

OBJECTIVE@#To explore the clinical effect of Qufu Shengji ointment(QFSJO) in promoting the wound healing after trauma.@*METHODS@#From January 2014 to June 2018, 60 patients with soft tissue injury, skin defect and wound infection caused by violent trauma were admitted, including 32 males and 28 females, aged from 18 to 65 years, with an average age of 41.3 years. Among them, 30 patients were treated with QFSJO (QFSJO group) and 30 patients were treated with normal saline iodophor (control group). The reduction rate of wound area, the days of decayed flesh, the time of new epithelium and the recovery rate of 28 days after dressing change were compared between the two groups.@*RESULTS@#In the QFSJO group, after using large dose of QFSJO, the pus of the wound increased, the granulation grew, and the new epithelium appeared on the edge of the wound, showing a rapid healing phenomenon. The wound healing rate of QFSJO group was higher than that of the control group at all time points, and the time of decaying flesh and new epithelium appeared in QFSJO group was earlier than that of the control group. The recovery rate of QFSJO group was significantly higher than that of the control group(<0.05). All the patients were followed up, and the duration ranged form 6 to 12 months, with an average of 9.4 months. The exposed areas of bone and teadon were covered well. The vital signs of the two groups were stable and no adverse reactions occurred.@*CONCLUSIONS@#QFSJO can promote the growth of granulation tissue, promote the production of new skin, and accelerate the healing of infectious wound after trauma.

Observation on clinical efficacy of contact thrombolysis via radial artery or femoral artery pathway for treatment of patients with acute ischemic stroke / 中国中西医结合急救杂志

Objective To compare the clinical efficacy of contact thrombolytic therapy between transradial artery intervention (TRI) and transfemoral artery intervention (TFI) pathways in patients with acute ischemic stroke (AIS). Methods The clinical data of 64 patients with AIS consistent with the indication of arterial thrombolysis in the People's Hospital of Huimin County of Shandong province from January 2010 to October 2017 were treated with arterial contact thrombolysis after exclusion of contraindications, including 42 cases treated with TRI (TRI group) and 22 cases treated with TFI (TFI group), and they were analyzed retrospectively. The differences in success rate of puncture, puncture time, the interval between the sheath set to the artery and the catheter reaching the diseased vessels, the re-canalization rate of occlusive vessels, surgical time, puncture site bleeding and intracranial bleeding complications and clinical outcomes in the patients were compared between the two groups. Results The comparisons of following indicators between the TRI group and TFI group were as follows: success rate of puncture [97.6% (41/42) vs. 100.0% (22/22)], puncture time (minutes: 5.5±2.0 vs. 5.4±2.3), the interval between sheath set to the artery and catheter reaching the diseased vessel (minutes: 6.2±3.8 vs. 6.7±3.9), occlusive vascular re-canalization rate [45.2% (19/42) vs. 40.9% (9/22)], operation time (hours: 1.50±0.38 vs. 1.45±0.32), incidence intracranial bleeding complications [9.52% (4/42) vs. 9.09% (2/22)], and the differences in above indicators in comparisons between the two groups had no statistical significance (all P > 0.05); however, the complication of bleeding at puncture site in TRI group was significantly lower than that in TFI group [0 vs. 22.7% (5/22), P < 0.05]. There was no statistical difference in clinical outcomes between the two groups. Conclusion It is safe and effective to treat patients with AIS by the TRI approach.

Use of double lumen microcatheter in interventional treatment of chronic total occlusion lesions at bifurcation / 中国介入心脏病学杂志

Objective To evaluate the efficacy and safety of double lumen microcatheters in chronic coronary artery total occlusion(CTO)lesions at bifurcation during percutaneous coronary intervention(PCI).Methods From October 2013 to March 2015,we retrospectively analysed the application of double lumen microcatheter with bifurcation CTO lesions and reviewed the patients' clinical features,coronary angiography,intervention operation success rate,complications rates and incidence of major adverse cardiac events(including all-cause death,nonfatal myocardial infarction and target vascular remodeling).Results Twenty-three CTO lesions at bifurcation were treated with double lumen microcatheters,stenting were performed in 21 lesions and 2 lesions only received PTCA due to small blood vessel size.The operation success rate was 100％.All the 11 right coronary lesions and 3 left coronary lesions were managed using single stenting technique.Double stenting strategy was used in 9 left coronary lesions including 4 cases with mini-crush technique,4 cases with modified culottes technique and one case with modified T technique.All double stenting procedures were completed by kissing balloon expansion.There was no major adverse cardiac event occured during and after operation.Conclusion Double lumen microcatheters are useful in PCI treatment of bifurcation CTO lesions.

Photoelectrochemical water reduction over wide gap (Ag,Cu)(In,Ga)S2 thin film photocathodes.

The effects of partial replacement of Cu with Ag in a Cu(In,Ga)S2 (CIGS) thin film on its structural, optical, electrostructural, and photoelectrochemical (PEC) properties were investigated, in order to improve its performance for PEC water reduction under sunlight illumination. Results from X-ray diffraction (XRD) analyses revealed the successful partial replacement of Cu with Ag to form solid-solutions with different Ag/(Ag + Cu) ratios (A(x)CIGS, x = Ag/(Ag + Cu) = 0.1, 0.2, 0.3 and 0.4), as confirmed by a gradual change in the (112) reflections to smaller 2θ angles with increasing Ag/(Ag + Cu) ratio. Analyses of the photoabsorption properties of the materials using photoacoustic spectroscopy indicated changes in the band gap energies associated with increasing the Ag/(Ag + Cu) ratio. In addition, valence band maximum potentials of A(x)CIGS were deepened gradually with increasing Ag/(Ag + Cu) ratio. After modifying these A(x)CIGS films with a CdS ultrathin (ca. 70 nm) layer and a Pt catalyst, the PEC water reduction properties were evaluated in an electrolyte solution with the pH adjusted to 6.5, under simulated sunlight (AM 1.5G) radiation. Compared to the CdS- and Pt-modified Ag-free A(x)CIGS (A(0)CIGS) films, appreciable enhancements in the PEC properties were observed for electrodes based on A(x)CIGS (x > 0) films, and the best PEC performance was obtained for the electrode based on the A(0.2)CIGS film. However, the electrode derived from the A(x)CIGS film with Ag/(Ag + Cu) ratios higher than 0.3 showed diminished PEC properties due to the partial conversion of its semiconducting properties from p-type to n-type.

Managing a grossly comminuted and infected mandibular fracture using a maxillary extra-oral distractor as stabilizing agent: A clinical case report.

Facial fracture management dates as early as Hippocratic era. Comminuted mandibular fractures are one of the challenging clinical condition requiring high surgical expertise to achieve a good functional and esthetic outcome. In presence of infection and other facial fractures managing comminuted mandibular fracture becomes more challenging. Here we present a case of grossly comminuted and infected mandibular fracture with delayed presentation managed by using maxillary distractor as stabilizing agent. Using a maxillary distractor for managing a fractured mandible has been seldom reported in literature. Current case report gives idea to practicing clinician about the possibility of treatment beyond the established principles.

Efficacy analysis of fecal microbiota transplantation in the treatment of 406 cases with gastrointestinal disorders / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for gastrointestinal disorders.</p><p><b>METHODS</b>Retrospective analysis of the clinical data of 406 patients who underwent FMT from May 2014 to April 2016 in the Intestinal Microenvironment Treatment Centre of Nanjing General Hospital was performed, including patients with constipation(276 cases), recurrent Clostridium Difficile infection (RCDI, 61 cases), ulcerative colitis(44 cases), irritable bowel syndrome (15 cases) and Crohn's disease(10 cases). Donors were completely unrelated, 18- to 50-year-old non-pregnant healthy adult, with healthy lifestyle and habits, without taking antibiotics, probiotics and other probiotics history within 3 months. There were three routes of FMT administration: patients received 6 days of frozen FMT by nasointestinal tube placed in the proximal jejunum under gastroscope (319 cases); patients received capsules FMT per day for 6 consecutive days (46 cases) or once 600 ml of treated fecal liquid infusion into colon and terminal ileum by colonoscopy(41 cases).</p><p><b>RESULTS</b>Clinical cure rate and improvement rate of different diseases receiving FMT were respectively as follows: RCDI was 85.2% (52/61) and 95.1%(58/61); constipation was 40.2%(111/276) and 67.4%(186/276); ulcerative colitis was 34.1%(15/44) and 68.2% (30/44); irritable bowel syndrome was 46.7% (7/15) and 73.3% (11/15) and Crohn disease was 30.0%(3/10) and 60.0%(6/10). RCDI had the best efficacy among these diseases(P<0.01). There was no significant difference between the three routes of FMT administration(P=0.829). The clinical cure rate and improvement rate of different routes were 43.3%(138/319) and 58.6% (187/319) respectively in nasogastric transplantation group, 41.5%(17/41) and 61.0%(25/41) in colonoscopy group, 37.0%(17/46) and 63.0% (29/46) in the capsule transplantation group. There was no serious adverse event during the follow-up. The most common side effects were respiratory discomfort (27.3%, 87/319) and increased venting (51.7%, 165/319) in nasogastric transplantation group. Diarrhea was the most common complication in colonoscopy group (36.6%, 15/41). The main symptoms were increased venting (50.0%, 23/46) and nausea(34.8%, 16/46) in oral capsule group. Side effect symptoms disappeared after the withdraw of nasogastric tube, or at the end of treatment, or during hospitalization for 1-3 days.</p><p><b>CONCLUSIONS</b>FMT is effective for many gastrointestinal disorders. No significant adverse event is found, while the associated mechanism should be further explored.</p>

Short and long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision / 中国现代普通外科进展

Objective:To explore the short,long term efficacy and improvement of quality of life of patients with breast cancer after radical mastectomy by Stewart transverse incision.Methods:Collecting 104 patients with breast cancer from May 2009 to May 2013 in the hospital,55 cases of breast cancer were treated with Stewart transverse incision (the experimental group)and 49 cases were treated with traditional vertical incision for breast cancer (the control group).All the patients were treated with adjuvant chemotherapy.To observe the skin healing of the incision in the two groups after operation.Patients were followed up for 3-48 months,compared with two groups the incidence of postoperative complications,recurrence and metastasis and improve the quality of life.Results:Compared with the control group,the healing rate of grade A was significantly improved in the experimental group,the difference was statistically significant(P＜0.05).There was significant difference between the experimental group and the control group (P＜0.05).The incidence of complications such as flap fluid and upper limb edema was lower in the experimental group than in the control group,but the difference was not statistically significant (P＞0.05).The local recurrence,remote metastasis and 4-year survival rate of the experimental group were better than the control group,but the difference was not statistically significant (P＞0.05).The quality of life of the two groups of patients,the experimental group score in all areas were higher than the control group,the difference was statistically significant (P＜0.05).Conclusion:Stewart transverse incision breast cancer radical surgery is more conducive to wound healing,postoperative local recurrence rate,incidence of complications and psychological impact on patients were significantly reduced.And effectively improve the quality of life of patients after surgery.

Three-dimensional finite element analysis of the cantilever fixed bridge supported by implants with different shapes / 中国组织工程研究

BACKGROUND: The shape of the implant exerts an effect on its biomechanics. At present, the research of implant-supported fixed partial denture with cantilever extension mainly focuses on the same shape, and little is reported on the comparison and analysis of implant-supported fixed partial denture with cantilever extension supported by different shape implants.OBJECTIVE: To compare the biomechanical behaviors of cantilever fixed bridges which were supported by three different implants, including cylindrical implant, tapered implant, expandable implant, in the mandibular posterior region with the help of three-dimensional finite element analysis. METHODS: The three-dimensional finite element models of the cantilever fixed bridges which were supported by cylindrical implant, tapered implant and expandable implant and their surrounding tissue in the mandibular posterior region were established were established. The force of 300 N was applied to the cantilever fixed bridges with axial 90° and buccolingual 45° to evaluate the maximum von Mises stress (Max EQV stress) of cortical bone and cancellous bone and the maximum displacement in implant-abutment complex.RESULTS AND CONCLUSION: Under axial and buccolingual loads, the Max EQV stress in the cortical bone was higher than that in the cancellous bone. The cantilever fixed bridge which was supported by expandable implant had the lowest Max EQV stress in the cortical bone, especially under axial load, and exhibited the highest Max EQV stress in the cancellous bone. The cantilever fixed bridges supported by three different implants showed an increase in the Max EQV stress of the cortical bone and cancellous bone and the maximum displacement in implant-abutment complex under buccolingual load. The cantilever fixed bridge which was supported by expandable implant had the minimum maximum displacement in the buccolingual direction. To conclude, the cantilever fixed bridge which is supported by expandable implant has best stability.