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Levetiracetam （LEV） is the second generation of broad-spectrum anti-epileptic drug. LEV has the advantages of rapid absorption， short half-life， precise efficacy， good tolerance and few drug interactions. In order to improve the clinical efficacy of LEV， and reduce the occurrence of adverse reactions， children， pregnant women， the elderly， and patients with renal insufficiency should receive therapeutic drug monitoring （TDM）. Clinically， the samples are usually plasma or serum， and the TDM methods are mostly immunoassay or chromatography. There is currently no consensus on the effective concentration range of LEV， and the correlation between plasma concentration and adverse reactions is also unclear. The main factors affecting LEV plasma concentration include age， pregnancy， and patient compliance. How to interpret TDM results and adjust dosage based on the results will be the focus of future work.
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ObjectiveTo establish the specific chromatogram and thin layer chromatography（TLC） identification method of Kaixinsan（KXS） samples， in order to clarify the key quality attributes and provide reference for the quality evaluation of KXS. MethodHigh performance liquid chromatography（HPLC） specific chromatogram of KXS was developed with YMC Hydrosphere C18 column（4.6 mm×250 mm， 5 μm）， the mobile phase was acetonitrile（A）-0.2% formic acid aqueous solution（B） for gradient elution（0-15 min， 2%-20%A； 15-25 min， 20%-25%A； 25-30 min， 25%-30%A； 30-45 min， 30%-31%A； 45-50 min， 31%-44%A； 50-65 min， 44%-45%A； 65-73 min， 45%-75%A； 73-95 min， 75%-100%A； 95-105 min， 100%A； 105-105.1 min， 100%-2%A； 105.1-120 min， 2%A）， the detection wavelength was 320 nm. Ultra high performance liquid chromatography-linear ion trap-electrostatic field orbitrap mass spectrometry（UHPLC-LTQ-Orbitrap MS） was used to identify the chemical components of KXS with electrospray ionization（ESI）， negative ion mode and scanning range of m/z 50-2 000. TLC identification methods for Poria and Ginseng Radix et Rhizoma in KXS were established. ResultThere were 11 common peaks in the specific chromatogram of KXS， attributed to Polygalae Radix， Poria and Acori Tatarinowii Rhizoma. Taking peak 9（α-asarone） as the reference peak， the relative standard deviations of the retention times of 15 batches of KXS samples were<0.2%. A total of 34 compounds were identified by UHPLC-LTQ-Orbitrap MS， including terpenoids， phenylpropanoids， oligosaccharides and ketones. The established TLC had good separation and was rapid， reliable， simple， feasible， suitable for the identification of Poria and Ginseng Radix et Rhizoma in KXS. ConclusionThe specific chromatogram and TLC of KXS are stable and reproducible. The material basis of KXS is basically clarified by MS， which can provide a reference for the development and quality control of KXS.
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ObjectiveTo establish the specific chromatogram and thin layer chromatography（TLC） of Qingxin Lianziyin（QXLZY） benchmark samples， in order to clarify the key quality attributes and provide a reference for the quality evaluation of QXLZY. MethodHigh performance liquid chromatography（HPLC） specific chromatogram of QXLZY benchmark samples was developed by using a YMC Hydrosphere C18 column（4.6 mm×250 mm， 5 μm） with the mobile phase of acetonitrile（A）-0.2% formic acid aqueous solution（B） for gradient elution（0-10 min， 5%-20%A； 10-20 min， 20%A； 20-25 min， 20%-24%A； 25-40 min， 24%-30%A； 40-55 min， 30%-50%A； 55-65 min， 50%-100%A； 65-75 min， 100%A； 75-75.1 min， 100%-5%A； 75.1-90 min， 5%A）， and the detection wavelength was 360 nm. Ultra-high performance liquid chromatography-linear ion trap/orbitrap mass spectrometry（UHPLC-LTQ-Orbitrap MS） with electrospray ionization（ESI） was used to identify the components of QXLZY benchmark samples by accurate relative molecular weight and multilevel MS fragment ion information， the detection conditions were positive and negative ion modes and data dependency scanning mode. TLC identification methods for Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY were established. ResultA total of 15 characteristic peaks were identified from Glycyrrhizae Radix et Rhizoma， Plantaginis Semen and Scutellariae Radix， and the relative standard deviations of the retention times of 15 characteristic peaks in 15 batches of QXLZY benchmark samples were≤3% with peak 8（baicalin） as the reference peak. A total of 100 compounds， including flavonoids， organic acids， saponins， amino acids and others， were identified in the benchmark samples by UHPLC-LTQ-Orbitrap MS. The established TLC had good separation and was suitable for the identification of Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY. ConclusionThe material basis of QXLZY benchmark samples is basically determined by MS designation and source attribution. The established specific chromatogram and TLC of QXLZY are simple， stable and reproducible， which can provide a reference for the development and quality control of QXLZY.
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Objective:To investigate the current status of chronic respiratory disease (chronic obstructive pulmary disease, bronchial asthma and obstructive sleep apnea) management capacity in community health centers in Beijing Miyun district.Methods:From November 21 to 22,2018,nineteen community health centers and 65 general practitioners in Miyun district of Beijing were selected to participate in a questionnaire survey. The self-designed questionnaire was divided into two parts: the questionnaire for medical institutions(institution questionnaire)and questionnaire for general practitioners(doctor questionnaire). The institution questionnaires were distributed by the Miyun District Health Commission,and filled in by the person in charge of the institution; the knowledge questionnaires were sent to all general practitioners of 4 community health service centers. The two independent sample t test was used to compare the measurement data in accordance with normal distribution between the two groups, and analysis of variance was used for multi group comparison. Results:Nineteen institution questionnaires were sent to all centers in the district and all 19 valid questionnaires were recovered. Among them, 18 centers thought that chronic respiratory diseases should be included in the management of chronic non-communicable diseases, and health records should be established to achieve regular follow-up monitoring, but only one center had put asthma in the record. Nine centers purchased pulmonary function instrument; 8 centers were equipped with inhaled glucocorticoid, and 1 center was equipped with β 2-receptor agonists. The effective recovery rate of knowledge questionnaire was 100.0% (65/65). There was no significant difference in the knowledge scores of three kinds of chronic respiratory diseases (chronic obstructive pulmary disease, bronchial asthma, obstructive sleep apnea) among general practitioners [(63±19), (64±23), (62±21), F=0.087, P>0.05]. The scores of general practitioners with different ages and professional titles were (57±15), (66±13), (42±16) and (54±19), (67±12), (68±11) respectively. There were significant differences in the knowledge scores of general practitioners with different ages and professional titles ( F= 8.582 and 6.079, all P<0.05). The average scores of general practitioners with age>50 years or junior professional title were lower than others. Conclusions:The leaders of each center in Miyun district have a clear understanding of the necessity of diagnosis and treatment of chronic respiratory diseases, but there are still some problems, such as insufficient attention to chronic respiratory system, insufficient investment in disease management infrastructure, and lack of professional knowledge of chronic respiratory diseases among general practitioners. It is hoped that in the future, chronic respiratory diseases can be introduced into public health service projects, investment in related disease infrastructure will be strengthened, and comprehensive respiratory knowledge and ability training courses suitable for grass-roots general practitioners can be popularized as soon as possible.
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The incidence rate of ovarian cancer ranks the third among female malignant tumors, the mortality rate ranks the first and the prognosis is poor. Ovarian cancer poses a serious threat to the health of women's lives. The incidence of ovarian cancer is related to heredity, endocrine disorders and adverse lifestyle factors. In recent years, some scholars have carried out the impact of lifestyle, especially shift work, on the occurrence and development of ovarian cancer. Shift work can lead to circadian disruption, which affects hormonal balance in the body and may be a risk factor for ovarian cancer. This review summarizes four cohort studies and two case-control studies on the relation between shift work and ovarian cancer. The conclusion of the studies is inconsistent, suggesting that further researches are needed.
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PURPOSE@#This study was designed to compare the clinical efficacy of "8" and "0" wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.@*METHODS@#From September 2011 to September 2018, patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retrospectively. Patients with patellar fractures combined with distal femoral fractures, tibial plateau fracture or preoperative lower limb dysfunction were excluded. The patients treated with the "8" tension band wire fixation system and Kirschner wire were taken as Group A; those treated with the "0" fixation system and Kirschner wire were taken as Group B; those treated with the "8" fixation system and double-head cannulated compression screw were taken as group C; and those treated with the "0" fixation system and double-head cannulated compression screw were taken as group D. Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed, an X-ray examination was performed to identify fracture healing. The time of fracture healing and postoperative complications of the four groups were compared. One year after the operation, knee function was evaluated by Bostman's score.@*RESULTS@#During the study period, 168 patients with patellar fractures were treated by operations, and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau. As a result, 80 patients were included in this study, 20 in each group. All the patients were followed up for an average period of 12.2 months. Compared with Group A, patients in Group D presented less postoperative discomfort in the prepatellar region, quicker fracture healing, less fixation failure and better postoperative knee function scores (all p 0.05).@*CONCLUSION@#The "0" wire fixation system combined with a double-head cannulated compression screw seems to be more beneficial than the other three fixation systems for the treatment of transverse patellar fractures.
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Objective:To investigate the relationship between the arterial blood lactic acid level after entering the intensive care unit (ICU) and the 28-day mortality of patients with septic shock.Methods:The clinical data of 303 patients with septic shock hospitalized in the department of critical medicine of the Affiliated Hospital of Jining Medical College from April 2015 to June 2019 were analyzed retrospectively. According to the blood lactate (Lac) level, the patients were divided into <4 mmol/L group ( n=203), 4-10 mmol/L group ( n=69) and >10 mmol/L group ( n=31). The baseline characteristics of the patients were analyzed. Multiple logistic regression analysis was used to analyze the independent influencing factors of the 28-day mortality of patients with septic shock. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of the Lac level after entering the ICU for 28-day mortality, and Kaplan-Meier survival curve was performed according to the best cut-off value. Results:A total of 303 patients with septic shock were included, with 179 died in 28 days, and the total mortality was 59.08%. There were 203, 69, 31 patients in Lac<4 mmol/L, 4-10 mmol/L and >10 mmol/L group, respectively. There were significant differences in Acute Physiology and Chronic Health Evalution Ⅱ (APACHE Ⅱ), Sequential Organ Failure Assessment (SOFA), oxygenation index (PaO 2/FiO 2), abdominal infection, the proportion of vasoactive drugs use among the three groups ( P<0.05). Multiple logistic regression analysis showed that the independent influencing factor of the 28-day mortality of septic shock were age, SOFA, use of mechanical ventilation, lactic acid (Lac). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting 28-day mortality of patients with septic shock was 0.604 5 (95% CI: 0.540 8-0.668 2). When the optimal cut-off value was 3.55 mmol/L, the sensitivity was 0.508 4, the specificity was 0.733 9, the positive likelihood ratio was 1.910 3 and the negative likelihood ratio was 0.669 9. According to the best cut-off value of entrance Lac, patients were divided into high Lac group (≥3.55 mmol/L) and low Lac group (<3.55 mmol/L), and their 28-day mortality rates were 73.39%(91/124) and 49.16%(88/179). Kaplan-Meier survival curve showed that the 28-day cumulative survival rate of the high Lac group was significantly lower than that of the low Lac group ( P<0.001). Multiple logistic regression analysis showed that after adjusting for confounding factors, the 28 d mortality increased to 1.22 times for each increase of 1 mmol/L of Lac [odds ratio ( OR)=1.22, 95% confidence interval (95% CI) was 1.08-1.37, P=0.001 4]. The 28 d mortality in high Lac group was 3.53 times higher than that in low Lac group ( OR=3.53, 95% CI was 1.36-7.09, P=0.000 4). Conclusions:In patients with ICU septic shock, the arterial blood Lac level after admission was associated with 28-day mortality. Patients with septic shock whose arterial blood Lac level exceeded 3.55 mmol/L within 1 hour of entering the room had a significantly increased risk of death.
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The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.
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The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.
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The aim of this paper is to analyze the global patent layout of ibrutinib, the patent layout of key themes, and the original research company's patent layout of ibrutinib, so as to provide a reference for the related domestic drug companies to be acquainted with the patent status of the drug, and to select and decide their breakthrough points and market competition strategies. In this study, the drug name and drug structure were used as keywords for search in the patent databases CNABS and DWPI, and the results were combined with the search results from the International Online Search System STN. Then, the patent with ibrutinib as the invention point was selected and used for further analysis. Pharmacyclics has applied for 26 patents on ibrutinib in China, and the subject matter relates to compounds, compositions, new uses, dosage forms, preparation methods and so on. Among them, 4 patents have been granted, 8 patents have been rejected or overdue, and 14 patent applications are still pending. In order to break through the patent barriers of ibrutinib, Chinese pharmaceutical companies should always pay much attention to the patent approval process and the expiration status of patents from the original research company, and make full use of the intellectual property system to effectively protect their own innovations.
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Objective@#To build an automatic bone age assessment system based on China 05 Bone Age Standard and the latest deep learning technology, and preliminary clinical verification was carried out.@*Methods@#The left-hand radiographs of 5 000 children with suspected metabolic disorders were acquired from Wuxi Children′s Hospital. Among these cases, 2 351 patients were randomly chosen as training set, and 101 patients were randomly used as validation set. Four professional pediatric radiologists annotated the development stage according to the China 05 RUS-CHN standard with double-blind method. The mean value of the bone age assessed by experts was the reference standard which was used to train and validate the deep learning mothods based artificial intelligence (AI) model. Accuracy, mean absolute error (MAE), root mean squared error (RMSE) and time efficiency of bone age assessment were compared by using Chi-square test and t test and F test between resident doctors and AI model in the validation set.@*Results@#The MAE and RMSE was (0.37±0.35) years and 0.50 years between AI model and reference standard, respeactively. When the error range was within ±1.0, ±0.7 and ±0.5 years, the accuracy of model on the validation set was 94.1% (95/101), 89.1% (90/101), 74.3% (75/101) respectively. The accuracy between two resident doctors and AI prediction wasn′t statistical significant (P>0.05).@*Conclusion@#The AI model of bone age assessment based on deep learning is feasible and has the characteristics of high accuracy and efficiency.
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Objective To observe the effect of Qingzao-Jiufei decoction and its composition on the levels of IL-10,TNF-α, CD4+cells, CD8+T cells and the change of CD4+/CD8+ratio in the serum to explore the mechanism of anti-MP infection. Methods The 144 SPF grade BALB/c mice were randomly divided into the normal group, the model, the whole decoction group, the composition Ⅰ group, the composition Ⅱgroup with the method of random digital table, and the azithromycin group and every group had 24 mice. The following five groups were treated with infection of MP model. After successful modeling, the rats in the whole decoction group were treated by gavage with 1 g/ml Qingzao-Jiufei decoction. The rats in the composition Ⅰ group were treated by gavage with 0.61 g/ml composition Ⅰ decoction. The rats in the composition Ⅱ group were treated by gavage with 0.39 g/ml composition Ⅱ decoction. And the three groups were administered for 14 days. The rats in the azithromycin group were treated by gavage with azithromycin suspension once a day. After three days, the drug was stopped. Each group was infected on 3,7,10,14 day. Then mice were sacrificed, with the method of taking the eye of the mice to take blood. The level of IL-10, TNF-α in the mice blood with the method of ELISA were detected. The level of CD4+, CD8+T in the rinsing solution of mice spleen with the method of FCM and the CD4+/CD8+ ratio were detected. Results Compared with the model group, the expressions of CD4+T cells (24.50 ± 1.41 vs. 22.08 ± 1.99) and IL-10 (18.15 ± 0.36 vs. 8.75 ± 0.16) in the whole decoction group significantly increased. The expressions of CD8+T cells (7.29 ± 1.23 vs. 9.13 ± 1.14) and TNF-α (28.32 ± 1.90 vs. 37.97 ± 1.71) significantly decreased (P<0.05), and the level of CD4+/CD8+ratio increased. In the composition Ⅰ group, the expressions of CD8+T cells (7.50 ± 1.45 vs. 9.13 ± 1.14) and TNF-α(33.48 ± 1.08 vs. 37.97 ± 1.71) significantly decreased (P<0.05). In the composition Ⅱ group, the expressions of CD4+T cells (23.63 ± 1.10 vs. 22.08 ± 1.99) and IL-10 (17.82 ± 0.63 vs. 8.75 ± 0.16) significantly increased (P<0.05). Conclusions The mechanism of Qingzao-Jiufei decoction on anti-MP infection may be related to the regulation of the cellular immune.
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The experimental SD rats were randomly divided into normal control group (Con group),diabetic ulcer model group (DM group) and Celastrol group (Cel group).Except the control group,diabetic ulceration rat models were established by intraperitoneal injection of streptozotocin along with skin scald.And then,each group was treated by spraying the saline solution on the affected skin with (Cel group) or without (Con group and DM group) Cel (q.d.×14 d).Nuclear magnetic resonance (NMR)-based metabonomic analysis was applied to detect metabolic characteristics,accompanied by healing rate calculation and HE and Masson staining to study therapeutic effect of celastrol on accelerated healing of skin wounds of diabetic ulceration rats,which could be used to elucidate therapeutic effects of celastrol on the rat diabetic ulceration and its mechanism.The results showed that celastrol could induce epithelial regeneration of the rat ulcer wound,regulate the infiltration of inflammatory cells and the distribution of collagen fibers,and promote the healing of the ulcer wound.About 20 endogenous potential differential metabolites were screened and identified by partial least square analysis.Metabolic pathway analysis was carried out to show that celastrol can significantly recovery the level of the tricarboxylic acid cycle,promote its energy supply,accelerate the protein synthesis,improve mitochondrial dysfunction and oxidative stress,and accelerate the self-repair ability of skin tissue.Celastrol can promote the healing of ulcers skins of the diabetic rats,which contribute to experimental basis of the drugs for the treatment of diabetic ulcers.
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Purpose To investigate the prognostic value of whole-body magnetic resonance imaging (WB-MRI) for patients with multiple myeloma (MM).Materials and Methods Sixty-two newly diagnosed patients with MM confirmed by pathology during January 2010 and December 2016 were enrolled in this study.The patients were divided into five groups according to the infiltrative patterns on MRI:normal pattern,micro-nodular pattern,macronodular pattern,mixed pattern and diffuse pattern,and their overall survival were compared.Results Of all the patients,micro-nodular infiltrative pattern was found in 20 patients,macro-nodular pattern in 13 patients,mixed pattern in 7 patients and diffuse pattern in 17 patients,while 5 patients were normal.During the follow-up for a median of 39 months (ranged 30.9-47.1 months),overall survival with the mixed MM infiltrative pattern (median 17 months,95％ CI 12.6-21.3 months) was statistically shorter than those with other patterns (median 43 months,95％ CI 33.7-52.3 months;P＜0.05).Additionally,the clinical DurieSalmon (DS) and International Staging System (ISS) were applied to evaluate the stage of MM patients.DS system showed that 6 patients were at stage I,another 6 patients were at stage Ⅱ and the other 50 patients were at stage Ⅲ.While based on ISS system,15 patients were found at stage Ⅰ,22 patients were at stage Ⅱ and the rest 25 patients were at stage Ⅲ.Meanwhile,the correlation between the WB-MRI infiltrative pattems and DS system as well as ISS system had no significant correlation (P＞0.05).Conclusion Different infiltrative patterns in WB-MRI can predict the prognosis in patients with MM at the time of diagnosis.
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Objective To identify related anatomical parameters and the strongest risk predictor leading to patients with recurrent patellar instability.Methods 52 young patients with recurrent patellar instability that failed of conservative treatment were retrospec-tively evaluated by MRI.Measurements included parameters of patellar tracking,which was characterized by bisect offset index (BSO),trochlear congruence angle (CA)and patellar lateral tilt (PTA),and anatomical parameters of patellofemoral joint,which were characterized by the sulcus angle (SA),lateral trochlear inclination (LTI),trochlear facet asymmetry,trochlear depth,Insall-Salvati Ratio (ISR),Caton-Deschamps index (C-D)and tibial tuberosity-trochlear groove (TT-TG)distance.The collection data were analyzed including the Pearson's correlation and multiple stepwise regression analysis.Results The patellofemoral joint ma-lalignment was significantly correlated with LTI,TT-TG distance and ISR,but not or partly with the trochlear depth,SA,trochlear facet asymmetry and C-D.Linear regression models including LTI,TT-TG distance and ISR explained 0.58,0.47 and 0.43 of the va-riance in BSO,CA and PTA,respectively (P<0.001).And the standardized beta coefficient was largest for LTI,then were TT-TG distance and ISR.Conclusion At full extension of the knee,anatomical related factors measured on MRI explain some degree of re-current lateral patella shift and tilt,the strongest predictor among anatomical related factors that could lead to maltracking is LTI, and then are TT-TG distance and ISR.
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The present work is to study the chemical constituents from petroleum ether fraction of Tibetan medicine Swertia chirayita by column chromatography and recrystallization. The structures were identified by physical and chemical properties and spectral data as swerchirin (1), decussatin (2), 1,8-dihydroxy-3,5,7-trimethoxyxanthone (3), 1-hydroxy-3,5,7,8-tetramethoxyxanthone (4), bellidifolin (5), 1-hydroxy-3, 7-dimethoxyxanthone (6), methylswertianin (7), 1-hydroxy-3,5-dimethoxyxanthone (8), erythrodiol (9), oleanolic acid (10), gnetiolactone (11), scopoletin (12), sinapaldehyde (13), syringaldehyde (14), and β-sitosterol (15). Compounds 3, 4, 9, 11-14 were isolated from S. chirayita for the first time. Compounds 9 and 12 were firstly isolated from the genus Swertia. The cytotoxic activities of compounds 1, 2, 5, 7 and 8 against human pancreatic cancer cell lines SW1990 and BxPC-3,and the protective effects of these compounds against hydrogen peroxide (H2O2)-induced oxidative stress in human endothelium-derived EA.hy926 were investigated in vitro. The results showed no obvious effect at the high concentration of 50 μmol•L⁻¹.
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Objective To observe the clinical efficacy of needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride.Method Ninety-three patients with early Parkinson's disease were randomized into group A of 32 cases, group B of 30 cases, and group C of 31 cases. Group A was intervened by needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride, group B by rehabilitation and taking levodopaand benserazide hydrochlo-ride, while group C by taking levodopaand benserazide hydrochlo-ride. UPDRSⅢ scores and Berg balance scale (BBS) scores were observed.Result After intervention, UPDRSⅢ scores and BBS scores were significantly changed in all groups (P<0.05). UPDRSⅢ scores of group A were markedly different form that of group B and C (P<0.05). BBS scores of group A and B were markedly different form that of group C (P<0.05).Conclusion Needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride can improve motor function and equilibrium function in the early Parkinson's disease patients.
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Objective To explore the relationship between osteoporosis knowledge and activities and fear of falling of elderly in the community.Method 420 elders in community were investigated with osteoporosis knowledge assessment tool (OKAT) and the modified survey of activities and fear of falling in the elderly (MSAFFE).Result The overall average score of MSAFFE was (25.36±4.58),and exercise capacity dimension scored higher (13.89±2.41).The overall average score of OKAT was (9.11±3.81).The correlation coefficient of MSAFFE and OKAT was-0.11～ 0.58(P＜0.05).The level of knowledge osteoporosis could explain 24％,18％,16％ variation of activities and fear of falling in each dimension.Conclusion The level of knowledge osteoporosis in the elderly is closely related to activity and fear of falling.Health education should be strengthened to improve the life quality of older people.
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<p><b>OBJECTIVE</b>To evaluate the applicability of immune-related response criteria (irRC) in treating non-small cell lung cancer (NSCLC) by Chinese medicine (CM).</p><p><b>METHODS</b>Totally 97 stage III a-IV NSCLC patients were predominantly treated with comprehensive CM. Curative effects were evaluated by three methods such as Response Evaluation Criteria in Solid Tumors (RECIST), Oncologic Curative Effect Evaluation Criteria of Chinese Medicine in Solid Tumor (draft, abbreviated as CM criteria), and irRC. The correspondency and consistency between irRC, RECIST and CM criteria were analyzed and compared. The objectivity of irRC in evaluating curative effect of Chinese medical treatment for NSCLC was assessed.</p><p><b>RESULTS</b>The correspondency rate of irRC to RECIST was 59. 79% with Kappa value of 0. 379 (U test, P <0. 01). The two criteria had certain correspondence, but with an unsatisfactory consistency. The correspondency rate of irRC to CM criteria rate was 83. 51% with Kappa value of 0.751 (U test, P <0. 01). The two criteria had good correspondence and consistency.</p><p><b>CONCLUSIONS</b>CM criteria had good consistency with CM criteria in evaluating curative effect for Chinese medical treatment of advanced NSCLC. Its results could objectively reflect features and advantages of CM for treating advanced NSCLC.</p>
Subject(s)
Humans , Asian People , Carcinoma, Non-Small-Cell Lung , Drug Therapy , Allergy and Immunology , Drugs, Chinese Herbal , Therapeutic Uses , Lung Neoplasms , Drug Therapy , Allergy and Immunology , Medicine, Chinese Traditional , Reference Standards , Treatment OutcomeABSTRACT
Objective To investigate on the students' network usage,addiction and influencing factors at a certain university and analyze its correlation with impulsive choice.Methods Multi-class sampling method was applied.1 777 students were selected from the School of Clinical Medicine,School of Nursing,School of Public Health,School of Mental Health,School of Medical Laboratory Science,Department of Stomatology,School of Pharmacy,School of Management and Department of Biology,including 1 534 medical majors,accounting for 86.3％ and 243 non-medical majors,accounting for 13.7％.Results 121 students were addicted to the internet,accounting for 6.8％ of the selected students,while 1 656 students were free from the internet addiction,accounting for 93.2％ of the selected students.Among all the addicts,96 were from medical majors,accounting for 79.3％ and 25 were from non-medical majors,accounting for 20.7％.As for the online activities,boys loved computer games while girls preferred to watch movies,listen to music and shop.At the same time,most of the junior students and non-medical majors played games online.As for the length of time,students spending 5 and more hours everyday on the internet accounted for 3.4％.As for the sites,medical majors usually used their cell-phones while non-medical majors mostly got on line at their dorms.Probably due to the boys' preference for computer games,a larger proportion of boys getting on line at school dorms and internet bars off the campus.Most of the girls chose to use their cell-phones.More junior students surferred the internet at dorms while more senior students used their cell-phones.As for the function of the medical knowledge on the prevention and treatment of internet addiction,9.8％ of the students held that medical knowledge had a great effect on the prevention and treatment of internet addiction,61.5％ believed in a general effect,while 28.6％ of the students thought it useless.The multi-factor analysis showed that grade,home address and the communication with parents all attribute to internet addiction.Internet addiction was significantly associated with impulsiveness,and 3 dimensionality of impulsive choice (P＜ 0.01).Conclusion There is higher incidence of internet addiction among the junior students,students from the urban areas and those who lack communication with parents.Grade,home address and situation of communicating with parents are the important factors for internet addiction.Internet addiction is close association with impulsive choice.