Research progress in immunoregulation mechanism of bone trauma microenvironment / 中华创伤杂志

Trauma induces immune cells to infiltrate the fracture site, and regulates the removal of local dead bone and remodeling of new bone by secreting a variety of cytokines and inflammatory mediators. With the development of trauma immunology, the role of the immune system in the process of bone wound healing has been deeply studied in recent years. When fracture occurs, the non-specific and specific immune cells are successively attracted into the fracture site, participating in bone repair. If there was a disorder in the bone trauma microenvironment, the coordination between osteoblasts and osteoclasts will be disordered, leading to delayed or nonunion of fractures. Therefore, it is very important to systematically explore the communication between immune cells and immune cells or osteoblasts/osteoclasts in bone trauma microenvironment. The authors review the immune regulation mechanism in the process of bone clearance and repair after bone trauma, and provide a rationale for the future immunotherapy of bone trauma.

Analysis of foodborne disease outbreaks in schools in Zhejiang Province during 2010-2019 / 中国学校卫生

Objective@#To understand the epidemiological characteristics of foodborne disease outbreaks in schools in Zhejiang province, and to provide evidence for effective prevention and control of foodborne disease outbreaks in schools.@*Methods@#A descriptive analysis was conducted on foodborne disease outbreaks in Zhejiang schools reported by the national foodborne disease outbreaks surveillance system from 2010 to 2019.@*Results@#During the past 10 years, a total of 86 foodborne disease outbreaks in schools were reported, with 1 755 illnesses, 240 hospitalizations, and no deaths. Pathogenic bacteria and their toxins were the main causes of foodborne disease outbreaks in schools, accounting for 83.0%(44/53) of all identified causes. The top four types of pathogenic bacteria were Staphylococcus aureus, Salmonella, diarrheagenic Escherichia coli, and Bacillus cereus. Meat products and mixed foods were the main foods that caused the outbreaks, each accounting for 16.3%(14/86) of total incidents. High school cafeterias were places with the highest incidence, accounting for 38.4%(33/86) of the total. School concession stands caused the largest number of hospitalizations, accounting for 37.1%(89/240) of the total. The peak month of foodborne disease outbreaks in schools was September, followed by June, May, and October. Crosscontamination and improper storage were the main causes of foodborne disease outbreaks in schools.@*Conclusion@#Bacterial foodborne disease is a major food safety issue in schools in Zhejiang Province. In summer and fall, school cafeterias and food stores should take effective measures to prevent bacterial foodborne disease outbreaks caused by cross-contamination and improper storage of high-risk foods such as meat products and cold-processed bakeries.

Dynamic scalp acupuncture combined with PNF therapy for upper limb motor impairment in ischemic stroke spastic hemiplegia / 中国针灸

<p><b>OBJECTIVE</b>On the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.</p><p><b>METHODS</b>A total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.</p><p><b>RESULTS</b>The MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).</p><p><b>CONCLUSION</b>PNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.</p>

The Measurement Analysis of Doctor Workload Based on the Analytic Hierarchy Process / 中国卫生经济

Objective: To search for the weighting the doctor’s service value and method to give the payment to doctors. Methods:From the hierarchy of medical service items, medical service items are classified, the weight of medical service item are calculated by analytic hierarchy process (AHP) , the Harvard University doctor workload measurement model is established. Results: According to the weight of medical service items, to calculate the workload of doctors integrated with practical work quantity. Conclusion:By applying the theoretical results into practices, the estimation system of doctor workload was smoothly operated in the organization.

Two preventive interventions of postpartum hemorrhage / 中华全科医师杂志

A total of 358 high-risk pregnant women were divided randomly into observation (A) and control (B) groups.Group A:15ml 10％ calcium gluconate was injected intravenously during the second stage of labor at full dilatation.And 10 U oxytocin was injected intramuscularly upon an immediate delivery of fetal anterior shoulder.Then 400 μg misoprostol was inserted into anus at 5 cm; Group B:10 U oxytocin was injected intramuscularly upon an immediate delivery of fetal anterior shoulder.Then 400 μg misoprostol was inserted into anus at 5 cm.Statistically significant differences existed in the amount of bleeding loss after delivery for 2 h and 24 h (P ＜ 0.01),the time limit of the third labor (P ＜ 0.01) and the occurrence rate of postpartum hemorrhage (P ＜ 0.01).No significant difference existed between two groups in the Apgar score of the first minute (P ＞ 0.05).An intravenous infusion of calcium gluconate plus oxytocin and misoprostol after birth could reduce the rate of postpartum hemorrhage.Worthy of clinical application,this method has no effect upon Apgar score.

The clinical effect of Redlining injection on acute lung injury / 中国基层医药

Objective To evaluate the clinical effect of the lung protective ventilation combining with Re-duning injection on the acute lung injury (ALI). Methods 59 patients with ALI were randomly divided into the lung protective ventilation group (control group, n =30) and the lung protective ventilation wmbined with Reduning injection group(experimental group,n = 29) ,and the changes of vital signs,RR,blood gas analysis,and so on were observed. The comparison between PaO2 and PaO2/FiO2 was carried out. The efficacy and the mortality rate were evaluated. Results Lung injury in 21 cases of experimental group were improved after applied Reduning treatment(72. 41%),there was a significant difference ( P < 0.05) with that of 14 cases in control group (46. 67% ) ; PaO2 increased, PaO2/FiO2 significantly increased in experiment group,there were significant difference compared with those of control group(P <0. 01). The mortality rate in the experimental group was 24.14% ,there was a significant differ-ence(P<0.05) compared with the mortality of 50. 00% in control group. Conclusion Reduning treatment could, improve the pulmonary function in lung protective ventilation to cure ALI,reducing the mortality rate as well.

Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial / 中西医结合学报

An increase in the incidence rate of hospital-acquired pneumonia (HAP) has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD), and how to prevent HAP is a growing concern to clinicians.

Application of reference methods suggested by IFCC and analysis of the 2006 ring trial results / 中华检验医学杂志

Objective To establish reference methods for the measurement of catalytic activity concentrations of enzymes at 37℃ which have been published by IFCC and evaluate accuracy of reference methods.Methods Six reference methods for the measurement of catalytic activity of enzymes were established with two sets of apparatus systems of PE and Agilent according to International Federation of Clinical Chemistry(IFCC)37℃ reference procedures in two reference labs respectively.The commercial Roche calibrator c.f.a.s was used to monitor the precision of two reference labs as quality control material.Certified Reference Materials(CRMs)represented an efficient tool to assess the analytic performance for the verification of trueness and in two labs.The measurement accuracy of the assays for catalytic activity concentrations of 6 enzymes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),gamma-glutamyhransferase(GGT),amylase(AMY)]was further verified and validated by international ring trial program.Results The within-laboratory variations of 6 enzymes in both of the reference lab were ranged from 0.5%-1.9%.Their results showed fully agreement with deviation less than 2.1%.The value of CRM was in the tolerant limit and analytic accuracy was verified.The results of four enzymes(ALT,AST,GGT,AMY)lay within (x)±s.However,the result of CK and LDH lay within (x)±2s.Except sample A for the LDH testing,we did not find any deviation variable in the detection of other enzymes.Conclusions The reference methods for the measurement of catalytic activity of enzymes(ALT,AST,LDH,CK,GGT,AMY)at 37℃ in the two labs by use of two sets of apparatus systems of PE and Agilent have been established and these methods showed excellent stability and accuracy.

Effect of Total Glucosides of Paeony on Bone Density, Protein Level of Skeletal Muscle and Relative Cytokine in Rat Model of Osteoporosis / 中国中医药信息杂志

Objective To determine the influence of total glucosides of paeony (TGP) on bone density, protein level of skeletal muscle and relative cytokine of osteoporotic rats. Methods Six-month-old SD rats were shamed as control (8 rats) or were ovariectomized (24 rats). The ovariectomized (16 rats) +TGP low dose and high dose group were treated with 50 mg/(kg?d) TGP and 150 mg/(kg?d) TGP respectively for 12 weeks. After the animals were sacrificed, IL-6, TNF-?, IGF-1, TGF-? in serum, protein level of skeletal muscle in right quadriceps femoris, and bone density of right femur and lumbar vertebra were determined. Results Compared with the ovariectomized group, the bone density and the protein level of skeletal muscle in TGP group increased significantly from the baseline (P