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ObjectiveTo analyze the effects of new integration processing method in producing area and traditional method on the composition and pharmacological action of Polygoni Multiflori Radix Praeparata（PMRP）， and to illustrate the advantages of toxicity reducing and efficacy enhancing of the decoction pieces prepared by the new method. MethodFresh Polygoni Multiflori Radix（PMR） was taken from Dao-di producing area， and was processed by new integration processing method in producing area（steaming with black bean juice under pressure of 0.1 MPa and temperature at 120 ℃ for 10.5 h） and traditional method（steaming with black bean juice under water for 36 h）， respectively. Samples were collected during the processing process of the two methods， For new method， the samples were collected at 0.5， 3， 5.5， 8， 10.5 h， separately. For traditional method， the samples were collected every 4 h. High performance liquid chromatography（HPLC） was used to establish fingerprint and identify common peaks， the content of polysaccharides was determined by anthrone-sulfuric acid colorimetry at 627 nm， and the contents of anthraquinones and stilbene glycosides in different processed products were determined according to the methods under the item of determination of PMR and PMRP in the 2020 edition of Chinese Pharmacopoeia. In pharmacological experiments， 90 SD rats were randomly divided into 9 groups with 10 in each group（half of male and half of female）， including the blank group， and raw products， 24 h processed products under atmospheric pressure， 30 h processed products under atmospheric pressure， 8 h processed products under high pressure groups with low and high dosages（4.125， 16.5 g·kg-1）. Rats were given the drug by gavage for 29 d with once a day， blood was collected from the abdominal aorta after the last administration， and the serum was isolated， the body mass and liver mass of rats were weighed and the organ index was calculated. The pathological change of liver tissue was observed by hematoxylin-eosin（HE） staining， and biochemical methods were used to detect the contents of aspartate aminotransferase（AST）， alanine aminotransferase（ALT）， alkaline phosphatase（ALP）， γ-glutamyltransferase（GGT）， lactic dehydrogenase（LDH） in serum which used as liver function indicators and the levels of superoxide dismutase（SOD）， malondialdehyde（MDA）， glutathione peroxidase（GSH-Px） in brain tissues which used as oxidation indicators. ResultA total of 14 common peaks were identified in the fingerprint of PMR， PMRP prepared by new method and traditional method， and three of the peaks were designated as stilbene glycoside， emodin and emodin methyl ether， respectively. The characteristic peak areas of each processed products changed significantly from 0 min to 25 min， indicating that different processing methods had an effect on the contents of components with high polarity in PMRP， and the trend of the changes of the two methods was similar， with the higher degree of change in the new method. The determination results showed that compared with the traditional method， the content of polysaccharide（a kind of beneficial component in PMRP obtained by the new method） significantly increased， while the contents of stilbene glycoside and bound anthraquinone（liver-damaging ingredients） significantly decreased. The pharmacological results showed that compared with the blank group， AST and LDH levels of male rats in the low and high dose groups of 24 h processed products under atmospheric pressure and AST level of male rats in the low and high dose groups of 8 h processed products under high pressure were significantly reduced（P<0.05， P<0.01）， while compared with the raw product groups with the same dose， AST and LDH levels of male rats in the low dose group of 30 h processed products under atmospheric pressure were significantly reduced（P<0.05， P<0.01）， the AST levels of male rats in the low and high dose groups of 8 h processed products under high pressure were significantly decreased（P<0.01）， and there was no statistical significance in the differences of biochemical indexes of female rats in each administration group as compared with those of the blank group. ConclusionThe new integration processing method in producing area of PMRP can reach the quality of relevant regulations in 8 h. The processed products obtained by this method have more advantages than the traditional method in terms of toxicity reducing and efficacy enhancing， and energy saving to avoid the loss of ingredients， which can provide ideas for the production of high-quality decoction pieces of PMRP， and the integration processing method in producing area of other roots and rhizomes of traditional Chinese medicines.
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Objective:To explore the teaching effect of magnetic on-demand teaching mode in nursing interns of neurology department.Methods:Forty-two nursing students who practiced in Neurology Department of Haikou People's Hospital from July 2019 to December 2019 were selected as the control group, and 44 nursing students who practiced from January 2020 to June 2020 were selected as the study group. The traditional teaching mode was adopted in the control group, while the magnetic on-demand teaching mode was adopted in the study group. The scores of theory and skill examination after teaching, nurses' core competence (evaluated by nurse core competence scale) before and after teaching, active learning rate and incidence of nursing errors during teaching and satisfaction with teaching were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:After teaching, the scores of theory and skills in the study group were significantly higher than those in the control group ( P<0.05). After teaching, the scores of core competence of nurses in the two groups were higher than before, and the scores of core competence of nurses in the study group were higher ( P<0.05). During the teaching period, the active learning rate of the study group was higher than that of the control group ( P<0.05), and the incidence rate of nursing errors was lower than that of the control group ( P<0.05). The satisfaction of all kinds of teaching in the study group was higher than that in the control group, with statistically significant differences. Conclusion:In the clinical teaching of nursing interns in neurology department, the magnetic on-demand teaching mode can significantly enhance the mastery of nursing theory and skills, improve the core competence of nurses, improve the active learning rate and teaching satisfaction, and reduce the occurrence of nursing errors.
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Objective:To investigate the predictive value of platelet reactivity for early neurological deterioration (END) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke within 48 h of onset admitted to the Department of Neurology, the Affiliated Haikou Hospital of Xiangya School of Medicine, Central South University from January 2017 to March 2019 were enrolled prospectively. Aspirin was taken on the day of admission, and the platelet aggregation rate was detected using a PL-11 Platelet Function Analyzer 7 d after taking it. END was defined as the National Institutes of Health Stroke Scale (NHISS) score at any time point within 7 d after admission increased by ≥2 or the motor function item score increased by ≥1 from baseline. The demographics, baseline data, imaging examination and laboratory findings of patients in the END and non-END groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of platelet aggregation rate for END. Results:A total of 230 patients were included in the study. They aged 63.24±9.75 years, 126 were females (51.4%). The median baseline NIHSS score was 6 (interquartile range, 4-10). The median time from onset to admission was 15 h (interquartile range, 9-28 h). There were 54 patients (23.5%) in the END group and 176 (76.5%) in the non-END group. There were significant differences in arachidonic acid-induced maximum platelet aggregation ratio (MAR-AA), epinephrine-induced maximum platelet aggregation ratio (MAR-EPI) and collagen-induced maximum platelet aggregation ratio (MAR-COL) between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that MAR-AA (odd ratio [ OR] 1.165, 95% confidence interval [ CI] 1.091-1.243; P<0.001) and MAR-EPI ( OR 1.035, 95% CI 1.006-1.067; P=0.023) were the independent risk factors for END in patients with acute ischemic stroke. ROC curve analysis showed that MAR-AA had good predictive value for END, and the area under the curve was 0.775 (95% CI 0.707-0.843; P<0.001). The optimal cut-off value was 21.80%. The sensitivity and specificity of MAR-AA for predicting END were 72.2% and 77.3%, respectively. Conclusions:The platelet function measured by PL-11 is closely related to the risk of END in patients with acute ischemic stroke. It has a better predictive value for END.
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OBJECTIVE： To establish HPLC fingerprints of Paeonia tactilora decoction pieces， and to conduct its cluster analysis and principal component analysis. METHODS： HPLC method was adopted. The determination was performed on SunFire® C18 column with mobile phase consisted of acetonitril-0.05％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 230 nm， the column temperature was 30 ℃， the collection time was 70 min，and sample size was 15 μL. Using paeoniflorin as reference， HPLC fingerprints of 26 batches P. tactilora decoction pieces from different habitats and 30 batches by different processed methods were established. The similarity of samples was evaluated by TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition） to confirm common peak. Cluster analysis and principal component analysis were performed by using SPSS 20.0 software. RESULTS： There were 9 common peaks in HPLC fingerprints of 26 batches of sample from different habitats， the similarity of which was higher than 0.880. Six peaks were identified， including gallic acid， catechin， albiflorin， paeoniflorin， 1，2，3，4，6-pentagalloylglucose and benzoylpaeoniflorin. Cluster analysis showed that 26 batches of samples were clustered into 2 categories when cosine distance was 15. S1-S21 were clustered into one category； S22-S26 were clustered into the other category. By principal component analysis， the accumulative contribution rate of two main components was 81.124％. There were 10 common peaks in HPLC fingerprints of 30 batches of sample by different processed methods， the simi- larity of which was higher than 0.970. Seven peaks were identified， including gallic acid， catechin， aplopaeonoside， albiflorin， paeoniflorin， 1，2，3，4，6-pentagalloylglucose and benzoylpaeoniflorin. Cluster analysis showed that 30 batches of samples were clustered into 2 categories when cosine distance was 25. B1-B10 were clustered into one category； C1-C10 and J1-J10 were clustered into the other category. By principal component analysis， the accumulative contribution rate of four main components was 86.887％. CONCLUSIONS： Established HPLC fingerprint， the results of cluster analysis and principal component analysis can provide reference for quality control of decoction pieces of P. tactilora.
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Diabetes mellitus is an independent predictor of high platelet reactivity after antiplatelet therapy in patients with ischemic stroke,and the latter is closely related to the increased risk of recurrence of stroke.The mechanisms of high platelet reactivity in patients with diabetes or insulin resistance are associated with a variety of factors.Some circulating molecules can be used as markers for predicting the reactivity of platelets.Monitoring of platelet reactivity after treatment with new antiplatelet agents may provide basis for individualized antithrombotic therapy in ischemic stroke patients with diabetes or insulin resistance.
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Sleep disorder is a common complication after is chemicstroke.If it is nottimely diagnosed and treated, it may affect the rehabilitation of stroke and recurrence. The manifestations of sleep disorders have various forms according to the different locations of infarction. For the treatment of sleep disorder after stroke, the method of the combination of drugs and physical therapy is used in clinical practice at present. In recent years, w ith the w idely use of the polysomnography, poststroke sleep disorders can be diagnosed clearly and carefuly. The treatment for sleep disorders after stroke may significantly improve the prognosis of patients.
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Clopidogrel can inhibit platelet aggregation and reduce the risk of recurrent stroke.However,it is a great difference in antiplatelet inhibition in different populations.This article reviews the mechanism of clopidogel resistance and its countermeasures in the prevention of ischemic stroke.
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Objective To investigate the relationship between biomarkers of renal function and cerebral microbleeds (CMBs) in cerebral hemorrhage patients.Methods This is a cross-sectional study including a total of 129 patients with cerebral hemorrhage.All patients underwent susceptibility weighted 3.0 T MRI.The presence and number of CMBs on susceptibility weighted MRI were independently interpreted.We calculated the urinary albumin/creatinine ratio (UACR) from morning spot urine and the estimated glomerular filtration rate (eGFR) in serum samples.Serum cystatin C (CysC) was measured using the automated particle-enhanced turbidimetric immunoassay.Results Among 129 patients with cerebral hemorrhage,86 (66.7％) had CMBs on susceptibility-weighted imaging.UACR (mg/g;20.47 ± 9.03 vs 35.24±14.83,t=3.823,P＜0.01)andCysC (mg/L;0.98±0.09vs 1.31 ±0.13,t=4.739,P＜0.01) levels were higher in the patients with CMBs than those without,and the eGFR (ml · min-1 · 1.73 m 2) was lower in the patients with CMBs than those without (78.07 ± 18.69 vs 61.59 ± 17.08,t =3.672,P ＜0.01).A Logistic regression analysis indicated that the levels of kidney impairment biomarkers were significantly associated with the prevalence of CMBs in cerebral hemorrhage patients after an adjustment for age,sex and other risk factors.The odds ratio (OR) and 95％ CI of each kidney biomarkers (eGFR,UACR,and CysC) for the CMBs status were 2.573 (1.172-5.315),2.735 (1.247-6.246)and 2.976 (1.764-6.968),respectively.CysC exhibited fair diagnostic value for CMBs,with an area under the curve of 0.835 (95％ CI 0.791-0.878).Furthermore,there were negative correlations between eGFR and the the number of CMBs (P =0.038,R2 total =0.216).There was a positive correlation between UACR,CysC and number of CMBs (P =0.024,R2 total =0.312;P =0.013,R2 total =0.375).Conclusions Elevated levels of kidney biomarkers are associated with the presence of CMBs in cerebral hemorrhage patients,independent of conventional risk factors.CysC may be a potential diagnostic biomarker for CMBs in cerebral hemorrhage patients.
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<p><b>OBJECTIVE</b>To measure the root anatomic topography of mandibular first molar using cone beam CT (CBCT), calculate the proper space for dowel preparation.</p><p><b>METHODS</b>The roots of 121 mandibular first molars from 71 patients were scanned by CBCT, the images from cross section, sagittal plane, and coronal plane were got respectively. The dowel preparation spaces according to established three dimensional images and dowel preparation requirements were analyzed.</p><p><b>RESULTS</b>Three dowels could be prepared. The dowel length for distal-root was (7.19 +/- 0.91) mm, dowel diameter was (0.80 +/- 0.12) mm on the level of 4mm above root apex. The dowel length for mesio-root was (6.92 +/- 1.02) mm, and dowel diameter was (0.71 +/- 0.08) mm on the lever of 4 mm above root apex for buccal side and (0.71 +/- 0.07) mm for lingual side. Dowel should be prepared cone-shaped.</p><p><b>CONCLUSION</b>Many factors affect dowel preparation, individualized design is needed. CBCT can provide reliable radiographic evidence.</p>