Investigation on the current situation of the development of intensive care units in Inner Mongolia Autonomous Region in 2022 / 中华危重病急救医学

OBJECTIVE@#To investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation.@*METHODS@#A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital.@*RESULTS@#As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet.@*CONCLUSIONS@#The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.

The exploration of pharmaceutical botany extracurricular activities practice / 中华医学教育探索杂志

Liaoning University of Traditional Chinese Medicine has conducted pharmaceutical botany extracurricular activities such as the experiment skill competition,fieldwork,specimen preparation,resources investigation,database construction,pharmaceutical plants cultivating and participating in scientific research projects etc.These activities have improved the students' learning enthusiasm,strengthened the effect of first classroom teaching,and have played a positive role especially in improving students' experimental skills and cultivating their innovative thinking and abilities,and improving teachers' quality.

Simultaneous determination of four acids active compounds in Erodium stephanianum by RP-HPLC / 中国中药杂志

<p><b>OBJECTIVE</b>To establish a RP-HPLC method for the determination of four acids compounds including gallic acid, protocatechuic acid, corilagin and ellagic acid in Erodium Stephanianum.</p><p><b>METHOD</b>The RP-HPLC separation was performed on an Agilent TC-C18 analytical column (4.6 mm x 250 mm, 5 microm). The mobile phase was methanol (A) -water containing 0.4% H3PO4 (B) with gradient elution mode at the flow rate of 0.8 mL x min(-1). The detection wavelength was set at 259 nm, and the column temperature was 30 degrees C.</p><p><b>RESULT</b>The liner ranges of gallic acid, protocatechuic acid, corilagin and ellagic acid were 0.059-2.360 g x L(-1) (r = 0.999 6), 0.017-0.672 g x L(-1) (r = 0.999 9), 0.351-14.040 g x L(-1) (r = 0.999 9), and 0.151-6.040 g x L(-1) (r = 0.999 8), respectively. The average recoveries (n = 3) were 99.45% (RSD 1.5%), 98.65% (RSD 1.7%), 100.3% (RSD 2.0%), and 98.90% (RSD 1.2%), respectively.</p><p><b>CONCLUSION</b>The method is simple and accurate with a good reproducibility and can be used for quality control of Erodium stephanianum.</p>

Expression and significance of cytokeratin-19, vimentin, vascular endothelial growth factor-C, and cyclooxygenase-2 in Graves' disease and Hashimoto's thyroiditis / 中华内分泌代谢杂志

ObjectiveTo study the roles of cytokeratin-19 ( CK-19 ),vimentin,vascular endothelial growth factor-C( VEGF-C ),and cyclooxygenase-2 ( COX-2 ) played in the occurrence and development of Graves'disease(GD) and Hashimoto's thyroiditis(HT).Methods57 cases of GD and 58 cases of HT were enrolled in our study.Immunohistochemistry using SP method was carried out for assessment of the expression of CK-19,vimentin,VEGF-C,and COX-2 in the thyroid tissues.Results CK-19,VEGF-C,and COX-2 were expressed in the cytoplasm of thyroid follicular epithelial cells.Vimentin was expressed both in the mesenchyma and in the cytoplasm of thyroid follicular epithelial cells.The positive rates and expression intensities of CK-19 and VEGF-C in HT ( 86.2％,96.6％ ) were significantly higher than those in GD ( 43.9％,56.1％,all P＜0.05 ).The expression intensities of vimentin and COX-2 in GD ( 100.0％,93.1％ ) were similar to those in HT ( 100.0％,91.2 ％ ),while the expression intensity of COX-2 in HT was significantly higher than that in GD( all P＜0.05 ).The positive rates of CK-1 9 were much higher in type Ⅲ ( 81.3％ ) of GD than in type Ⅰ ( 1 5.8％ ) and type Ⅱ ( 40.9％ ) of GD,and also higher in type P( 100％ ) of HT than in type L(66.7％ ) of HT.The positive rates of VEGF-C were much higher in type Ⅲ ( 87.5％ ) of GD than in typeⅠ ( 36.8％ ) and type Ⅱ ( 50.0％,all P ＜ 0.05 ) of GD.ConclusionImmunohistochemical detection of the expression of CK-19,vimentin,VEGF-C,and COX-2 may carry clinical significance in revealing the occurrence and development as well as evaluating the prognosis of Graves'disease and Hashimoto's thyroiditis.

Principal component analysis and cluster analysis of inorganic elements in Erodium stephanianum from different areas / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the characteristics of inorganic elements in Erodium stephanianum.</p><p><b>METHOD</b>The content of elements such as Li, B, Na, Mg, Al, Si, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Ga, Br, Rb, Sr, Ba, La, Ce and Rb in ten E. stephanianum samples were determined by means of ICP/MS. The results were used for the development of element distribution diagram. The principal component analysis of SPSS and Q-type cluster analysis were applied for the study of characteristic elements in E. stephanianum.</p><p><b>RESULT</b>Five principal components which accounted for over 91% of the total variance were extracted from the original data. The analysis results showed that Al, Ti, V, Fe, La, Ce, Li, Ga and Ba may be the characteristic elements in E. stephanianum; The results of Q-type cluster analysis showed that the samples could be clustered reasonably into two groups, and the elemental distribution characteristics were related to the ecology and origins of E. stephanianum.</p><p><b>CONCLUSION</b>The principal component analysis and Q-type cluster analysis could be used in data processing in inorganic elements.</p>

Analysis on the Relevant Factors of Distribution of TCM Syndrome for Ankylosing Spondylitis / 中国中医药信息杂志

Objective To analyse the relevant factors of distribution of TCM syndrome for ankylosing spondylitis (AS). Methods 194 AS patients visiting the department of Rheumat Immunity, Guanganmen Hospital, were investigated in the way of horizontal study. And the relationship between TCM syndrome and age, sextuality, staging, grading of sacroiliac joint, laboratory index was studied. Results It was no significant difference of AS TCM syndrome with different age, sextuality, early、medium、advanced stage, and grading of sacroiliac joint. But it was different between the active stage and inactive stage. For the laboratory index, the ESR and CRP of each syndrome was different, while the comparison with the data of blood routine examination was no evident difference. Conclusion The distribution of AS TCM syndrome on active stage is mainly about the retention of damp-heat, and the inactive stage is mainly on the deficiency of kidney-yang syndrome. Compared with other sydromes, ERS and CRP in the syndrome of retention of damp-heat are significantly high. It is no significant changes of syndrome on aspects of different age, early、medium、advanced stages, and grading of sacroiliac joint.

Analysis of fufang duzhong jiangu keli in improvement of knee joint function in 400 cases of knee osteoarthritis / 中国组织工程研究

BACKGROUND:According to the thrust of document issued by State Drug Administration, the clinical experiment was carried onfufang duzhongjiangu keli (compound) (Bo Si Zhuang) in treatment of knee joint osteoarthritis.OBJECTIVE: To evaluate the improvement of the compound in treatment of knee joint osteoarthritis and its safety.DESIGN: Zhuanggu guanjie wan (bolus) was taken as controlled drug and double blind, double-simulation randomized method was designed.SETTING: Fujian Institute of Chinese Medicine, Guananmen Hospital of China Academy of Traditional Chinese Medicine, Institute of Orthopedics and Traumatology of China Academy of Traditional Chinese Medicine and Beijing Hospital of Chinese Medicine.PARTICIPANTS: Clinical experiment Ⅱ was performed since December 19, 1999, in which, 200 cases of knee joint osteoarthritis were observed and divided into compound group (100 cases) and bolus group (100 cases).From December 1999 to March 2000, clinical experiment Ⅲ was performed to observe 400 cases of knee joint osteoarthritis, in which, 300cases were divided in compound group and 100 cases in bolus group. All of cases were diagnosed by X-ray test and differentiated in Chinese medicine as insufficiency of liver and kidney and stasis of tendons and vessels. All of patients were in the known of experiment.METHODS: In compound group, fufang duzhong zhuanggu keli (1bag/time, 3 times/day) + simulated dosage of zhuanggu guanjie wan were administrated. In bolus group, fufang duzhong zhuanggu keli simulated dosage + zhuanggu guanjie wan (1bag/time, twice/day) were administrated.Double blind and double-simulation randomized control experiment was given in one-month treatment to observe clinical therapeutic effects.MAIN OUTCOME MEASURES: Evaluation on clinical indexes of joint function ,clinical therapeutic effect, syndrome score in Chinese medicine and adverse reaction.RESULTS: Totally 600 cases employed had all accomplished datum collections, no dropped-off case. ① The total effective rate of compound group was superior remarkably to bolus group (92.%, 82%). ② The result of joint function in compound group was superior remarkably to that of bolus group. ③ Concerning to improvement of syndromes in Chinese medicine, the result in compound group was superior to that of bolus group (the decreased integrals were 7.03±3.38 and 5.43±3.16 respectively). ④No obvious harmful effect presented during experiment.CONCLUSION: Fufang duzhong jiangu keli improves the symptoms of osteoarthritis of knee safely and effectively.

The ethical requirement of the placebo-controlled clinical study / 中国医学伦理学

Placebo-controlled clinical study is the ethical issue being debated all over the time.The ethics committee plays an important role in the assurance of the scientificalness of clinical research without violation of ethics.This article introduces the main points considered in the placebo-controlled clinical study in Medical Ethics Committee of Guang'anmen Hospital of China Academy of Traditional Chinese Medicine.These points are as follows,the benefit of the subject greater than the risk,considerations on the benefit / risk of the subjects,the disposal of compensation measures and adverse events in research program and fully informed consent as well as the model of final resolution.