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OBJECTIVE To optimize the water extraction process of Maxing kechuan granules. METHODS With the contents of ephedrine hydrochloride， bergenin， prim-O-glucosylcimifugin， 5-O-methylvisamin， naringin and hesperidin and the rate of extraction as the evaluation indexes， the weight was determined by the analytic hierarchy process（APH）-entropy weight method， and the comprehensive score was calculated as the response value. Based on the single-factor test， the Box-Behnken response surface method was used to investigate the factors， and the best water extraction process of Maxing kechuan granules was optimized； process validation was also carried out. RESULTS The best water extraction process of Maxing kechuan granules optimized was as follows： soaking for 40 minutes， adding 8 times water， and extracting for 180 minutes. After three validation tests， the comprehensive score was 94.82 （RSD＝0.96%， n＝3）， which had a small difference from the predicted value of 94.64. CONCLUSIONS The water extraction process of Maxing kechuan granules is stable and reliable， which can provide a reference for the development of the preparation.
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Objective To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province.. Methods In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents’ demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis. Results A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ2 = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ2 = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey. Conclusions The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.
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OBJECTIVE To compare the efficacy， safety and economics of bid-winning and original Moxifloxacin hydrochloride tablets in the treatment of outpatient community-acquired pneumonia （CAP）. METHODS A retrospective cohort study was conducted to screen and include CAP outpatients during the period of January to December 2021 in Lianyungang First People’s Hospital. They were divided into generic drug group （1 058 cases） and bid-winning drug group （1 121 cases） according to the drug source. Two groups were respectively given original and bid-winning Moxifloxacin hydrochloride tablets， 0.4 g each time， once a day. The efficacy indexes （clinical effective rate， remission time， treatment course， revisiting rate） and safety indexes （allergy， nervous system symptoms， etc.） were compared between the two groups； and the influence factors of clinical treatment failure were analyzed with multi-factor modified Poisson regression model. The economic indicators of the two drugs [quantity， consumption sum， defined daily doses （DDDs）， defined daily dose cost （DDDc）， price ratio， replacement rate] were compared. RESULTS There were no significant differences in the clinical effective rate， treatment course， revisiting rate， the incidence of nervous system symptoms and Q-T interval prolongation between the two groups （P＞0.05）. The remission time of original drug group was significantly shorter than that of bid-winning drug group， and the incidence of total adverse drug reaction， allergy reaction， gastrointestinal symptom reaction and hyperglycemia were significantly lower than those in bid-winning drug group（P＜0.05）. Multivariate Poisson regression analysis showed that bid-winning drug did not increase the risk of clinical treatment failure in CAP outpatients [RR＝1.132， 95%CI （0.883， 1.542）， P＝0.327]. However， antibiotic exposure history， more than 2 items of abnormal clinical manifestations and auxiliary examination all increased the risk of clinical treatment failure （P＜0.05）. Compared with before the implementation of centralized volume-based procurement policy， the quantity and DDDs of Moxifloxacin hydrochloride tablets increased significantly， while the consumption sum decreased significantly， DDDc of bid-winning drug decreased significantly， the price ratio of it to original drug decreased to 0.117， and the replacement rate increased to 69.44% after the implementation of centralized volume- based procurement policy. CONCLUSIONS Compared with original drug， bid-winning Moxifloxacin hydrochloride tablet shows reliable efficacy and obvious price advantage in the treatment of outpatient CAP， but the incidence of adverse drug reactions is higher.
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OBJECTIVE To optimize the extraction technology of volatile components from Wuyao decoction. METHODS On the basis of single factor investigation ，the extraction technology of volatile components from Wuyao decoction was optimized and validated by Box-Behnken design-response surface technology using the contents of bomyl acetate ，cyperotundone，α-cyperone， ligustilide and dehydrocostuslactone ， extraction rate of volatile oil as indexes ， with extraction time ， soaking time and liquid-material ratio as factors. On this basis ，the extraction state of the decoction was quantified. RESULTS The optimal extraction technology was as followed ：the ratio of liquid -material was 13∶1（mL/g），soaking time was 0.5 h，and the extraction time was 6 h in the boiling state. The comprehensive scores of the three validation experiments were 0.948 7，0.948 4 and 0.948 6 respectively （RSD＝0.02％，n＝3），and the deviation from the predicted value （0.947 9）was no more than 1％. The boiling state of the decoction in 180 ℃ oil bath was taken as the sudden boiling state. CONCLUSIONS The optimized extraction technology is stable and feasible.
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OBJECTIVE To establish a comprehensive and rapid m ethod for the a nalysis of chemical constituents as phthalides and organic acids in Angelica sinensis ，and to provide scientific reference for the quality evaluation and pharmacodynamic substance research of A. sinensis . METHODS The 70％ ethanol extract of A. sinensis was analyzed by ultra high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry （UPLC-Q-TOF/MS）. The determination was performed on ACQUITY UPLC BEH-C 18 column with mobile phase consisted of 0.1％ formic acid solution- acetonitrile（gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was set at 30 ℃，and sample size was 2 µL. The ion source was an electrospray ion source ，using positive ion scanning mode ，and the mass scanning range was m/z 50-1 000. Capillary voltage was 4 000 V； atomizer pressure was 35 psi；cracking voltage was 135 V and the taper hole voltage was 65 V；the temperature of dry gas was 320 ℃；the flow of dry gas was 10 L/min and the flow of sheath gas was 11 L/min；collision energy were 20 and 40 V. Qualitative Analysis 10.0 software was used to obtain the retention time of compounds ，the accurate mass number of excimer ion peaks and secondary fragments. The compounds were analyzed by comparing with the mass spectra of the reference substance ，combined with relevant literature ，mass spectrometry cleavage law and database such as Chemspider ，MassBank，PubChem. RESULTS A total of 72 compounds were identified or deduced from A. sinensis ，including 55 phthalides，13 organic acids and 4 other constituents. CONCLUSIONS The established method is rapid and accurate for the identification of chemical constituents from A. sinensis ，such as organic acids and phthalides ，which provides an efficient and rapid analytical method for the comprehensive characterization of its chemical constituents.
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Objective:To discuss strategies in treatment of poorly differentiated thyroid carcinoma (PDTC) .Methods:Clinical data of 31 cases with PDTC were reviewed retrospectively, who were treated in Department of Head & Neck Surgery, Sichuan Cancer Hospital & Institute by primary surgical resection with or without adjuvant therapy. 27 cases had total thyroidectomy compounded neck dissection or extened total thyroidectomy when trachea or esophagus involved. 4 cases underwent partial resection of tumor. 11 cases were treated with external beam radiotherapy (EBRT) after surgery, 10 cases were treated with postoperative radioiodine, and 8 cases had chemotherapy.Results:The median follow-up time was 18 months (ranged from 3-96 months) . 19 patients died of local recurrence or distant metastasis. Kaplan-Meier analysis and Log-rank analysis was used to compare the differences between groups. Five-year survival was 35.9%. Compared to the cases with partial resection, the cases with surgical disease clearance had longer survival ( P=0.00) . The same statistical difference was found between patients with or without radioiodine ( P=0.017) . The patients treated with radioiodine had longer survival. No statistical differences were found among patients with or without chemotherapy or EBRT. COX regression analysis showed stage of tumor ( P=0.005) , total resection ( P=0.006) and postoperative radioiodine ( P=0.013) were same to predict longer survival. Conclusions:Thorough resection of tumor is the most important therapy for PDTC. Postoperative radioiodine is recommended for patients with high recurrence risk. EBRT is recommended to control local unresectable PDTC.
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Objective:To investigate the features of chest computed tomography (CT) imaging and dynamic changes of severe corona virus disease 2019 (COVID-19).Methods:The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results:The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and two cases presented with three lobes involved, one case with four lobes involved and 14 cases with five lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, three cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination, the lesions of eight patients showed continuous improvement, and those of the other eight patients showed fluctuating changes.Conclusions:The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with five-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.
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Objective:To investigate the effects and the mechanism of renal protection of curcumin on oxidative stress and lipid metabolism in diabetic rats.Methods:60 Wistar rats were randomly divided into normal control group ( n=20) and diabetic model preparation group ( n=40). Rats in the normal control group were fed with normal diet, while rats in the diabetes model group were fed with high sugar and high fat diet. After 4 weeks of feeding, rats in the diabetic model preparation group were injected with streptozotocin (60 mg/kg) intraperitoneally once. A total of 35 rats were successfully modeled and then randomly divided into diabetic model group ( n=17) and curcumin group ( n=18). The diabetic model group continued to be fed with high sugar and high fat diet, and the curcumin group was given high sugar and high fat diet and 200 mg/(kg·d) curcumin (1% carboxymethyl fiber sodium prepared into suspension) intervention every day; while the normal control group and the diabetic model group were given 1% carboxymethyl fiber sodium of the same volume. The body weight, kidney index, blood glucose , serum creatinine, urea nitrogen, blood lipid and 24-hour urinary microalbumin excretion rate (24 h UAER) of rats in each group were measured. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and m-alondialdehyde (MDA) in serum and kidney tissues were measured. Results:Compared with the control group, the levels of the body weight, kidney index, blood glucose, serum creatinine, urea nitrogen, triglyceride, total cholesterol and 24 h UAER in the diabetic model group increased significantly. The level of MDA in serum and kidney tissues increased significantly ( P<0.05), while the levels of SOD, CAT and GSH-Px activities in serum and kidney tissues decreased significantly ( P<0.05). Compared with diabetic model group, the levels of the body weight increased, while the kidney index, blood glucose, serum creatinine, urea nitrogen , triglyceride, total cholesterol and 24 h UAER in the curcumin group decreased significantly, the level of MDA in serum and kidney tissues decreased significantly ( P<0.05); the levels of SOD, CAT and GSH-Px in serum and kidney tissues increased significantly ( P<0.05) in the curcumin group. Conclusions:Curcumin may play a renal protective role in diabetic rats by inhibiting oxidative stress in serum and kidney and reducing blood lipid.
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Objective:To analyze the reform of improving the teaching effects of nursing college students' practical training.Methods:Cluster sampling method was used to select 396 nursing college students in a higher nursing school as the research objects, with 197 in experimental group and 199 in control group. Self-directed learning was adopted in practical teaching of surgical nursing in the students in experimental group, and traditional surgery teaching was adopted in control group. Self-rating scale of self-directed learning (SRSSDL) was used every 3 months during the period. The students' self-directed learning ability was measured dynamically, and the scores of practical examination and course satisfaction were compared between the two groups. The data were statistically analyzed by repeated measures analysis of variance and independent sample t-test using SPSS 17.0.Results:The scores of repeated measurement of SRSSDL in the experimental group were higher than those in the control group ( F=16.237, P=0.016). Except for the common surgical instruments module ( P=0.056), the scores of practical training examination in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.01 for the operating room nursing module, P=0.005 for the wound nursing module, P<0.01 for the enterostomy nursing module). The students' satisfaction with the overall curriculum in the experimental group was higher than that in the control group. Conclusion:Self-directed learning in the teaching of nursing practice can effectively enhance comprehensive ability and quality of students based on self-directed learning ability, and improve the teaching effect of practical training courses.
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High mobility group protein B1 (HMGB1) is a kind of nuclear protein widely existing in cells, which is released or secreted from cells by stress in the body and plays a key role in the survival or death pathways of cells. HMGB1 has a huge biological function and is the main regulator of major diseases such as inflammatory diseases and tumors. HMGB1 is closely related to the proliferation, differentiation, migration, apoptosis and drug resistance of tumor cells. With the continuous deepening of research on HMGB1, it is found that HMGB1 plays an important role in the occurrence, development, metastasis and drug resistance of breast cancer. Combined with the research status of HMGB1, the expression of HMGB1 in breast cancer is discussed to provide a new therapeutic scheme for clinical treatment.
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Objective@#To investigate the features of chest CT imaging and dynamic changes of severe coronavirus disease 2019 (COVID-19).@*Methods@#The clinical and computed tomography (CT) data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.@*Results@#The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and 2 cases presented with 3 lobes involved, one case with 4 lobes involved and 14 cases with 5 lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, 3 cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, two cases with lymphadenopathy with the short diameter of 1.0-1.2cm. Among 16 patients who underwent repeated CT examination, the lesions of 8 patients showed continuous improvement, and those of the other 8 patients showed fluctuating changes.@*Conclusions@#The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with 5-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Chest CT is useful for the evaluation for the therapeutic effects.
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Objective@#To summarize the clinical manifestations and treatment of retinal artery occlusion and cerebral infarction caused by facial injection of hyaluronic acid.@*Methods@#Fifteen cases (15 eyes) with vision lose caused by facial cosmetic injection of hyaluronic acid visited Xi＇an No.4 Hospital from December 2010 to January 2017. The clinical data were collected such as general medical history and treatment methods, and follow-up for 1 year.@*Results@#All patients were female, 22-41 years old, with average age of 33. All patients were injected with hyaluronic acid. For 8 patients the fillers were injected in the forehead, 3 patients were in the glabellar region, 3 patients were in the nasolabial fold, and 1 patient was in the temporal of left eye. All patients had vision lose after injection, the visiting time was 1 to 6 hours. 13 patients were central retinal artery occlusion (CRAO). 1 patient was retinal branch artery occlusion (BRAO), 1 patient was ischemic optic neuropathy (ION), 13 patients manifested as no light perception (NLP), 1 patient was 0.6, 1 patient was CF/30 cm, and 14 patients with cerebral infarction, manifested as headache, dizziness. All patients were given emergency treatment, and 9 patients had treated with interventional thrombolysis therapy. After treatment 11 patients, visual acuity had no significant improvement, but 4 patients improved. Headache, dizziness symptoms disappeared, but cerebral infarction lesions still existed on MRI.@*Conclusions@#Human face is a rich blood supply; vision loss and cerebral infarction could occur after injection of hyaluronic acid. After urgent treatment visual acuity is not improved obviously, eventually leading to irreversible visual impairment or even loss.
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Objective@#To explore the advantages and clinical efficacy of free chimeric perforator flap based on the descending branch of circumflex femoral artery applied to tongue reconstruction after advanced tongue cancer resection.@*Methods@#From October 2013 to December 2018, 57 cases received tongue and oral base reconstruction surgeries using the descending branch of circumflex femoral artery chimeric perforator flap, including 39 males and 18 females, ranged from 20 to 76 years old. And all cases were with stage T3 and T4 tongue cancers, including 35 cases of squamous cell carcinoma, 7 cases of low differentiation cancer, 5 cases of oncosarcoma, and 10 cases of adenoid cystic carcinoma. The tongue was reconstructed by using perforator flap and muscle flap to fill the dead space at the oral floor. The artery anastomoses with the superior thyroid artery or facial artery in the receiving area, and the vein anastomoses with the internal jugular vein in the receiving area. The shape, function and local complications of the reconstructed tongue were observed after operation.@*Results@#Of 57 cases, only one case had partial necrosis of flap, while other 56 cases with chimeric perforator flap survived. Postoperative gastric tube and tracheal cannula were removed in all patients, no cases with oral fistula. All donor sites were sutured in one stage. Postoperative radiotherapy was performed in 41 of the patients. All patients were followed up for 3 to 60 months (average of 20.7 months), with satisfactory esthetic and functional results in reconstructed tongues. Only linear scars were left in the donor areas of the legs, and no lower limb dysfunction was observed.@*Conclusions@#The descending branch of circumflex femoral artery chimeric perforator flap can used for repairing simultaneously the defects of both tongue and oral base. It is helpful to avoid the occurrence of oral fistula and to provide the reconstructed tongue with a good function. It is a good choice to use the descending branch of circumflex femoral artery chimeric perforator flap for tongue reconstruction after resection of advanced tongue cancer resection.
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OBJECTIVE： To optimize the water extraction technology of classic formula Taohe chengqi decoction. METHODS： Based on single factor test， combined with response surface methodology and information entropy theory， the soaking time， solid-liquid ratio and extraction time were investigated. Using the contents of rhein， amygdalin， cinnamaldehyde and glycyrrhizic acid in Taohe chengqi decoction as indexes， information entropy theory was used to assign weight coefficients to each evaluation index and calculate the comprehensive score. Through Design-Expert 10 software， the interactions of each factor were analyzed. Water extraction technology was optimized， and validation test was also performed. RESULTS： According to information entropy theory， the weight coefficients of rhein， amygdalin， glycyrrhizic acid and cinnamaldehyde were located at 0.097 6， 0.363 2， 0.173 5 and 0.365 7. The results of interaction analysis showed that the material-liquid ratio had a greater impact on the comprehensive score. The optimal water extraction technology of Taohe chengqi decoction were determined as that soaking time was 60 min； the ratio of material to liquid was 1 ∶ 10 （g/mL）； total extraction time was 130 min （extracting for 3 times， lasting for 65， 33， 32 min each time）. The results of verification test showed that RSD of content of each index component and the comprehensive score was less than 3％. CONCLUSIONS： The optimal water extraction technology is proved to be stable and feasible， which can provide the basis for the further development and utilization of Taohe chengqi decoction.
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OBJECTIVE： To compare the extraction effects of steam distillation method （SD） and extraction-azeotropic distillation coupling technology （WER） on the volatile oil from Citrus aurantium and Cyperus rotundus， so as to determine the suitable extraction method and improve the extraction technology of volatile components in Qizhi weitong granule. METHODS： SD and WER were used to extract the total volatile oil from C. aurantium and C. rotundus. t-test was conducted for the yield of volatile oil extracted by the two methods. GC-MS method was used to analyze the volatile oil， and the main components were determined. The relative content of main components was determined compared by area normalization method. GC-MS conditions included that Agilent HP-5 capillary column （30 m×0.25 mm ， 0.25 μm）， inlet temperature of 250 ℃， nitrogen as carrier gas， flow rate of 1 mL/min， split ratio of 20 ∶ 1， sample size of 2 μL， temperature programmed， electron bombardment， electron bombardment energy of 70 eV， scanning range of m/z 50-500. RESULTS： The appearance of volatile oil extracted by WER was more clear， with better product phase than that by SD. The average yield of volatile oil extracted by WER method were significantly higher than SD method （1.78％ vs. 1.48％， P＜0.01）. The volatile oil extracted by WER method and SD method contained 39 and 38 components， involving 38 common components. Among them， D-limonene， acetophenone， ketoenone and α-ketone were the main components of the total volatile oil from C. aurantium and C. rotundus， and the sum of the 4 main components was about 73.40％ （WER method） and 68.46％ （SD method） of the total components. CONCLUSIONS： Compared with SD method， WER method for extracting volatile oil from C.aurantium and C. rotundus is better in product， phase higher in yield and higher in content of active volatiles， and is more suitable for the extraction of volatile components in Qizhi weitong granule.
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OBJECTIVE： To establish the method for content determination of volatile oil of Schizonepeta tenuifolia and Forsythia suspensa， and to optimize the extraction technology of the volatile oil. METHODS： The contents of β-pinene and pulegone were determined by GC method. The determination was performed on Hp-5 capillary column. The detector was hydrogen flame ion detector with programmed temperature. The sample size was 0.5 μL， the split ratio was 70 ∶ 1， the carrier gas was nitrogen， the inlet temperature was 250 ℃， the detector temperature was 280 ℃， the air flow rate was 390 mL/min， the hydrogen flow rate was 36 mL/min， the tail flow rate was 15 mL/min， and the nitrogen flow rate was 1 mL/min. Based on single factor test， orthogonal test combined with information entropy method were used to optimize the extraction technology of S. tenuifolia and F. suspensa using soaking time， extraction time， material-liquid ratio and forsythia grain size as factors， with the extraction amount of volatile oil， the content of β-pinene and pulegone and their comprehensive score as indexes. RESULTS： The linear range of β-pinene and pulegone 1.575-7.875（r＝0.999 9） and 1.892-9.46 μg（r＝0.999 7）， respectively. The limits of quantitation were 0.10 and 0.25 μg； the limits of detection were 0.03 and 0.08 μg； RSDs of precision， stability and reproducibility tests were less than 2％ （n＝6）； the recoveries were 97.77％-100.01％ （RSD＝0.93％，n＝9） and 96.47％-99.00％（RSD＝0.89％， n＝9）. The optimal extraction technology was soaking 2 h， extracting for 6 h， 10-fold water （mL/g）， half a clove of granularity. Under this condition， the extraction amount of volatile oil， the contents of β-pinene and pulegone were 3.6 mL， 1 450.4 mg， 127.6 mg， respectively. RSD were 1.62％， 0.20％， 1.42％. CONCLUSIONS： Established method is simple， accurate and reproducible， and the optimal extraction technology is stable and feasible.
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Objective To assess the safety and feasibility of video electroencephalographic (VEEG) monitoring in preterm infants and critically ill neonates in neonatal intensive care unit (NICU). Method From December 2017 to June 2018, high risk infants were prospectively enrolled and received VEEG monitoring in our NICU. Their basic information, adverse events and disturbances of any procedure during VEEG monitoring were collected by specially-trained nurses. Result A total of 245 times of VEEG were recorded. The average gestational age (GA) was (32.1 ± 3.6) weeks, the birth weight (BW) was (1879 ± 757) g, the corrected GA (cGA) at VEEG monitoring was (33.8±3.3) weeks, and the average weight at VEEG monitoring was (2008±716) g. The earliest cGA at VEEG monitoring was 25+5 weeks, and the lowest weight at VEEG monitoring was 520 g. The average monitoring duration was (4.9±2.4) h, ranging from 3 to 20 hours. During VEEG monitoring, 80 cases (32.7％) received noninvasive ventilation, 43 cases (17.6％) mechanical ventilation. The adverse events during electrodes placement were oxygen desaturation in 8(3.3％) cases. During VEEG monitoring, local skin erythema were found in 4 cases (1.6％), and electrodes displacement in 2(0.8％) cases. The disturbances of any clinical procedures were reported in 18(7.3％) cases. No severe adverse events such as displacement of endotracheal tube nor events requiring cardiopulmonary resuscitation occurred during VEEG monitoring. Conclusion It is feasible and safe for trained NICU nurses to place electrodes for high risk neonates.
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Objective To compare the efficacy of the solid tumor evaluation criteria 1.1 (RECIST 1.1) and the revised solid tumor efficacy evaluation criteria (mRECIST) after chemotherapy in the hepatocellular carcinoma system.Methord Retrospective analysis of 34 patients with advanced hepatocellular carcinoma who underwent Folfox4 system chemotherapy from the Department of Hepatobiliary and Pancreatic Surgery of Dongfeng Hospital affiliated to Hubei Medical College from July 2017 to July 2018,including 24 males and 10 females.Spiral CT and/or MRI (four-phase) scans were performed 1 nonth,2 months,and every 2 months after treatment,and the effects were evaluated by RECIST 1.1 and mRECIST,respectively.The survival curve was drawn by Kaplan-Meier method,and log-rank test was used to compare survival curves.Result In 34 patients evaluated with the RECIST 1.1 criteria,0 patient showed complete remission (CR),6 patients partial remission (PR),20 patients stable disease (SD),and 8 patients progressive disease (PD).Using the mRECIST criteria,CR:0,PR:10,SD:17,and PD:7 patients.The Kappa value of the two methods was 0.271,95％ CI:0.010 ～0.535.The log-rank test showed that there was no significant difference in the survival curves of patients between PR,SD and PD in RECIST 1.1 (P ＞ 0.05).The cumulative survival rates were 40.0％,11.8％ and 0,respectively.The survival curves of patients with PR,SD and PD in mRECIST were statistically significant (P ＜ 0.05),and the cumulative survival rates were 37.5％,0,and 0,respectively.Conclusion The mRECIST criteria were more suitable than the RECIST 1.1 criteria in assessing efficacy of systemic chemotherapy for hepatocellular carcinoma.
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Objective To investigate ultrasonographic features of different pathological types of mucinous breast carcinomas (MBC), and to improve the diagnosis rate of MBC. Methods The ultrasonographic features of 42 MBC cases between January 2014 and December 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed according to pathological types. Results There were 24 cases of simple type and 18 cases of mixed type in 42 MBC cases (46 lesions in total). The coincidence rate of preoperative ultrasound diagnosis for cancerous lesions was 93.5 % (43/46), including 24 cases of 27 simple type lesions with oval form or lobulated (20/27, 74.1 %), clear boundary (21/27, 77.8 %), uniform internal echo (17/27, 63.0 %), posterior echo enhancement (11/27, 40.7 %), and 18 cases of 19 mixed type lesions with irregular shape (14/19, 73.7 %), unclear border (16/19, 84.2 %), uneven internal echo (13/19, 68.4 %), posterior echo attenuation (13/19, 68.4 %). The differences between the two types of ultrasound images were statistically significant (both P＜0.05). Of 42 cases, 76 axillary lymph nodes were transferred in 13 cases. Preoperative ultrasonography showed that 32 axillary lymph nodes enlargement were abnormal in 12 cases, and the detection rate was 42.1 % (32/76). The positive rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 87.5 % (21/24), 79.2 % (19/24), 8.3 % (2/24) in simple type and 83.3 % (15/18), 88.9 % (16/18), 5.6 % (1/18) in mixed type respectively. There was no significant difference in the positive rates of 3 kinds of molecular markers among two types (all P＞0.05). Conclusions Due to the different tissue components in different types of MBC, ultrasonic features show several differences. Simple type is similar to benign masses, while mixed type shows the characteristics of invasive carcinomas.
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OBJECTIVE: To provide scientific evidence for the further improvement of hospital antibacterial management, the formulation of related management decisions and long-acting mechanism. METHODS: Technique for order preference by similarity to ideal solution (TOPSIS) was used to select 8 evaluation indexes as utilization rate of antibiotics in the inpatients to synthetically evaluate the effect of antibacterial management in 10 third grade general hospitals of Xi'an from 2012 to 2016. RESULTS: Results of synthesis evaluation by TOPSIS method showed that the least effect was in 2012 [coefficient of proximity from the object of evaluation to the optimal value (Ci) =0]; the effect of antibacterials management was improved gradually during 2013-2015, and there was the best effect in 2015 (Ci=0. 918 3); but declined in 2016 (Ci=0. 838 5). Only one evaluation index (the rate of microbial examination in the inpatient receiving special use of antibacterials) was improved significantly in the 5 years(P＜0. 01), but there was no statistical significance in the data of other 7 indexes (P＞0. 01). CONCLUSIONS: The effect of antibacterials management in 10 third grade general hospitals of Xi'an was on the rise from 2012 to 2015, but was declined in 2016. It might be slack. A long-acting management mechanism of antibacterial management is needed to be established, in order to consolidate the achievements from "special rectification for clinical antibacterial use" and further improve the normal and dynamic operation of antibacterial management measure. TOPSIS method is objective and comprehensive method for synthesis evaluation of the effect of antibacterial management, and is of significance to antibacterial supervision and use.