Analysis of work stress and its influencing factors among nursing staff in Tianjin City / 中华劳动卫生职业病杂志

Objective: To explore the current situation of work stress among nursing staff in Tianjin City and analyze its influencing factors. Methods: From August to October 2020, 26002 nursing staff from tertiary hospitals, secondary public hospitals, secondary private hospitals, primary hospitals, and other medical institutions in Tianjin City were selected as objects, and their general situation and working stress situation were surveyed by the general information questionnaire and the Nurse's Work Stressor Scale. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of work stress among nursing staff. Results: The average age of 26002 nursing staff was (33.86±8.28) years old, and the average working years were (11.84±9.12) years. There were 24874 women (95.66%) and 1128 men (4.34%). The total score of work stress was (79.82±21.69), and the average score of workload and time allocation dimension was the highest (2.55±0.79). The results of multiple linear regression analysis showed that marital status (β=-0.015, P=0.014), employment form as contract system (β=0.022, P=0.001), post as clinical nursing (β=0.048, P<0.001), education level (β=0.024, P<0.001), age (β=0.050, P<0.001), working years (β=0.075, P<0.001), and professional title (β=0.036, P<0.001) were the influencing factors of work stress, which explained 22.8% of the total variation in work stress of nursing staff (F=24.25, P<0.001) . Conclusion: The work stress among nursing staff in Tianjin City is high, the corresponding departments and nursing managers should adopt scientific management methods to reduce the workload of nursing staff according to the influencing factors of work stress, so as to create a good atmosphere for further promoting the healthy development of nursing career and nursing industry in the new era.

Analysis of perioperative efficacy and safety of cytoreductive surgery in the treatment of colorectal cancer peritoneal metastases / 中华胃肠外科杂志

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.

Meta-analysis and GRADE evidence profile of Rimegepant in the treatment of acute migraine / 四川精神卫生

ObjectiveTo systematically evaluate the efficacy and safety of Rimegepant in the treatment of acute migraine. MethodsThe databases of CNKI， Wanfang and VIP database， PubMed， Embase， Cochrane Library， ClinicalTrials were searched to collect relevant literature on the treatment of Rimegepant in acute migraine. The pain freedom and Most Bothersome Symptom （MBS） freedom 2 hours after medication were the primary outcome indicators， and the other 11 indicators including pain relief 2 hours after medication were the secondary outcome indicators. The Meta-analysis was performed using RevMan 5.3， and the quality of evidence was evaluated using GRADE Profiler 3.6 for outcome indicators. ResultsA total of 4 randomized controlled studies involving 3 827 patients， including 1 840 patients in the experimental group and 1 987 patients in the control group. Meta-analysis results showed that， in terms of effectiveness， compared with the control group， the proportion of patients in the Rimegepant group who were painless 2 hours after medication （RR=1.67， 95 % CI： 1.44~1.94， P<0.01）， MBS free 2 hours after medication （RR=1.37， 95% CI： 1.24~1.51， P<0.01） and pain relief （RR=1.33， 95% CI： 1.25~1.41， P<0.01）， pain relief lasting 2~24 hours after medication （RR=1.59， 95% CI： 1.46~1.74， P<0.01）， pain relief lasting 2~48 hours after medication （RR=1.57， 95% CI： 1.42~1.74， P<0.01）， painless 2~24 hours after medication （RR=2.27， 95% CI： 1.62~3.20， P<0.01）， painless 2~48 hours after medication （RR=2.14， 95% CI： 1.52~3.02， P<0.01）， and no fear of light （RR=1.47， 95% CI： 1.32~1.64， P<0.01） and no fear of sound 2 hours after medication （RR=1.40， 95% CI： 1.19~1.64， P<0.01） was higher， the differences were statistically significant. In terms of safety， the proportion of patients with nausea （RR=1.70， 95% CI： 0.95~3.02， P=0.07）， urinary tract infection （RR=1.81， 95% CI： 0.84~3.91， P=0.13）， dizziness （RR=1.14， 95% CI： 0.49~2.63， P=0.77） or elevated transaminase （RR=0.76， 95% CI： 0.45~1.27， P=0.29） showed no statistically significant differences between the Rimegepant group and the control group. Based on GRADE criteria， evidence for Rimegepant in the treatment of acute migraine was of high or moderate quality. ConclusionRimegepant is effective for acute migraine， and the toxic effects are tolerable.

Comparison of two vasopressor protocols for preventing hypotension post-spinal anesthesia during cesarean section: a randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients.@*METHODS@#In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg-1·min-1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth.@*RESULTS@#In total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008).@*CONCLUSION@#In patients undergoing elective cesarean section with spinal anesthesia, norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia, and exhibited potential neonatal benefits.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT02542748; https://clinicaltrials.gov/ct2/show/record/NCT02542748.

Meta analysis of whether cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can improve survival in patients with colorectal cancer peritoneal metastasis / 中华胃肠外科杂志

Objective: To explore whether the cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) can improve the survival rate of colorectal cancer patients with peritoneal metastasis. Methods: The relevant studies were systematically retrieved from PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP database, and the study of French Elias' team on peritoneal metastasis was retrieved manually. Inclusion criteria: (1) The patients were colorectal cancer peritoneal metastasis. (2) There were CRS+HIPEC treatments (treatment group) and other treatments (control group). (3) Survival analysis data of treatment group and control group were available. (4) Types of studies were randomized controlled trials, cohort studies, or case-control studies. (5) The literature was in Chinese or English. Exclusion criteria: (1) studies without full-text; (2) studies without complete data. The literature screening and data extraction were carried out by two people independently, and the third person decided on the literature with differences. The extracted data included authors, year of publication, number of patients, time of enrollment, time of follow-up, studies design, treatment regimen, hazard ratio (HR) and 95% CI of treatment group and control groups. If the HR and 95% CI of the treatment group and control group were not provided in the literature, Engauge Digitizer 11.1 software was used to extract the time of follow-up and the survival rate at the corresponding time point from the survival curves of both groups, and the HR and 95% CI of both groups were calculated by combining the number of both groups. The quality of study was evaluated by Newcastle-Ottawa scale (NOS) or Cochrane collaboration's tool for assessing risk bias. STATA 15.1 software was used for statistical analysis. HR and 95% CI of both groups were pooled and analyzed. Inter-trial heterogeneity was assessed by Q test and I(2) statistics. When there was no significant heterogeneity (Q test: P≥0.10), fixed-effect model was used for pooled analysis. When significant heterogeneity existed (Q test: P<0.10), random effect model was used for pooled analysis, and subgroup analysis was used to find out the source of heterogeneity. Sensitivity analysis was used to evaluate the stability of the pooled results. Publication bias was assessed by Egger's test and Begg's test (P<0.05 indicated publication bias) and it is reflected by the visual symmetry of Begg's funnel plot on the natural logarithm of HR. Results: A total of 10 studies were enrolled in the meta-analysis, including 1 randomized controlled trial and 9 cohort studies. The risk of bias in 1 randomized controlled trial was uncertain, and 9 cohort studies were all higher than 7 points, indicating high quality literatures. There were 781 patients in treatment group receiving CRS+HIPEC and 2452 patients in control group receiving other treatment, including tumor cytoreductive surgery (CRS), palliative chemotherapy (PC) and intraperitoneal chemotherapy (IPC). The results of pooled analysis by random effect model showed that the OS rate in treatment group was significantly higher than that in control group (HR=0.43, 95% CI: 0.34-0.54), but the heterogeneity of the study was high (P=0.024, I(2)=52.9%). The subgroup analysis of different control treatments showed that the OS rate in treatment group was significantly higher than that in CRS control group (HR=0.63, 95% CI: 0.44-0.90), in PC control group (HR=0.37, 95% CI: 0.32-0.43), in CRS+ IPC control group (HR=0.60, 95% CI: 0.37-0.96), and the heterogeneity of each subgroup was low (CRS control group: P=0.255, I(2)=22.9%; PC control group: P=0.222, I(2)=29.9%; CRS+IPC control group: P=0.947, I(2)=0). Due to the low heterogeneity of subgroups, fixed-effect models were used to pool and analysis. The results of sensitivity analysis revealed that there was little difference between the pooled analysis results after each study was deleted, suggesting that the pooled analysis results were more reliable. Publication bias detection of each study showed Begg's test (P=0.088) >0.05 and Egger's test (P=0.138)>0.05. According to the Begg's funnel plot, the scatter point distribution was basically symmetric, indicating that there was no publication bias in the included study. Conclusion: CRS+HIPEC can improve the OS of patients with colorectal cancer peritoneal metastasis.

Clinical features of 42 cases of COVID-19 / 上海预防医学

Objective To investigate the clinical features, laboratory findings, chest CT findings and treatment of patients with COVID-19, and to analyze their relationship with prognosis. Methods From January to February 2020, the clinical data on the 42 patients with COVID-19 admitted to the Wenzhou Sixth People′s Hospital were analyzed retrospectively. Results The clinical symptoms of the 42 cases included fever (35 cases), cough (26 cases), fatigue (14 cases), aspiration (9 cases), sore throat (4 cases), muscle ache (5 cases), headache (2 cases), nausea (4 cases), diarrhea (6 cases) and abdominal pain (1 case).The absolute number of blood lymphocyte decreased to different degrees in 22 cases.Fourteen cases had lactate dehydrogenase obviously, with no obvious change in procalcitonin.The imaging manifestations were cloud-like and ground-glass-like high density shadows scattered outside the lungs, small flaky consolidation and bronchus inflating sign were seen locally.A few images showed diffuse high density, most of the lesions showed consolidation or striate change, and local fibrosis was formed in the lower lobes of both lungs. Conclusion Fever and cough are the first symptoms of COVID-19, and a few cases are associated with shortness of breath and diarrhea, accompanied by different degrees of systemic symptoms, but most of the patients improve their conditions after active antivirus, anti-infection, systematic symptoms improvement and supportive treatment.The disease is highly infectious and its condition changes rapidly.Therefore, early detection, early diagnosis and comprehensive treatment of the whole body as soon as possible are the keys to treatment.

Optimization of extraction technology for Toufu irrigation by orthogonal test / 药学实践杂志

Objective To optimize the extraction process and improve the quality of Toufu irrigation.Methods Matrine assay was selected to be the indicator for the extraction efficacy.Orthogonal test was used to determine the optimal water a-mount,extraction time and extraction frequency.Results The best extraction process was to extract 90 minutes twice with the water amount 8 times of the dry herbal material by weight.Conclusion This process is feasible and repeatable.It can be used for the quality control of the preparation.

Research progress of relationship between capecitabine related gene polymorphisms and hand-foot syndrome / 实用肿瘤学杂志

In recent years,capecitabine is widely used in clinical practice.Hand-foot syndrome is a dose-limiting toxicity, often manifested as numbness in the hands and feet,sensation of dullness,tingling,skin swelling or erythema,scaling,blisters or seri-ous pain.Its occurrence has seriously affected the chemotherapy effect and daily life of patients.Genetic mutations of capecitabine met-abolic enzymes play an important role in the drug efficacy and side-effect.In particular,the relationship between gene polymorphisms of CDA,CES,TP,DPD,TYMS,MTHFR and hand-foot syndrome has been widely investigated and achieved by researchers.This arti-cle reviews the relationship between capecitabine metabolizing enzymes and hand-foot syndrome in order to provide a reference for i-dentifying the biological target of hand-foot syndrome caused by capecitabine chemotherapy.

Mild form disseminated photocoagulation treatment for moderate non-proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To observe the therapeutic effect of the mild form disseminated photocoagulation treatment for moderate non-proliferative diabetic retinopathy (MNPDR). ·METHODS: Prospective randomized controlled study. Totally 126 cases (209 eyes) with MNPDR were randomly assigned to two groups in ophthalmology department of Shanghai Shidong Hospital. There were 62 cases ( 103 eyes ) were treated with the mild form disseminated photocoagulation as the therapy group, 64 cases ( 106 eyes) were treated with control of blood glucose as the control group. All cases were followed up for 24mo. The best corrected visual acuity ( BCVA), fundus change and central visual field were observed and compared. · RESULTS: At 24mo after treatment, BCVA variety between two groups took on significant statistical difference which indicated that there were more eyes with improved or stable visual acuity in therapy group ( Hc=5. 942, P<0. 05). There was significant difference in fundus examination between two groups which indicated that there were more eyes with improved or stable fundus change in therapy group (Hc=12. 662, P<0. 05). There was no significant difference in average mean sensitivity (MS) between before and after laser therapy for 12mo (t=3. 1586, P>0. 05). During our follow-up, there were no complications likewise infection, hemorrhage, retinal membrane, injury of the macular fovear occurred. · CONCLUSION: The mild form disseminated photocoagulation therapy for moderate non-proliferative diabetic retinopathy is safe and effective without obvious complications, which can effectively delay the progression of diabetic retinopathy.

Transurethral diode laser enucleation versus transurethral electrovaporization resection of the prostate for benign prostatic hyperplasia with different prostate volumes / 中华男科学杂志

Objective@#To compare the clinical effect of diode laser enucleation of the prostate (DIOD) with that of transurethral resection of the prostate (TURP) on benign prostate hyperplasia (BPH) with different prostate volumes.@*METHODS@#This retrospective study included 256 BPH patients treated by DIOD (n = 141) or TURP (n = 115) from March 2012 to August 2015. According to the prostate volume, we divided the patients into three groups: 80 ml (48 for DIOD and 39 for TURP). We obtained the relevant data from the patients before, during and at 6 months after surgery, and compared the two surgical strategies in operation time, perioperative levels of hemoglobin and sodium ion, post-operative urethral catheterization time and bladder irrigation time, pre- and post-operative serum PSA levels, International Prostate Symptoms Score (IPSS), post-void residual urine (PVR) volume and maximum urinary flow rate (Qmax), and incidence of post-operative complications among different groups.@*RESULTS@#In the 80 ml group (［3.35 ± 1.39］ ng/ml vs ［1.76 ± 0.91］ ng/ml, P <0.05). No blood transfusion was necessitated and nor postoperative transurethral resection syndrome or urethral stricture observed in DIOD. However, the incidence rate of postoperative pseudo-urinary incontinence was significantly higher in the DIOD (22.7%, 32/141) than in the TURP group (7.83%, 9/115) (P <0.05).@*CONCLUSIONS@#DIOD, with its obvious advantages of less blood loss, higher safety, faster recovery, and more definite short-term effectiveness, is better than TURP in the treatment of BPH with medium or large prostate volume and similar to the latter with small prostate volume.

Current status of pharmaceutical management in traditional Chinese medicine pharmacy in state-run medical institutions in Jiading district, Shanghai / 药学实践杂志

Objective To evaluate the current status of traditional Chinese medicine(TCM) pharmacy in state-run hospitals in Jiading district in order to improve the quality of TCM pharmacy management.Methods 16 medical institutions were investigated.Among them, there are 1 traditional Chinese medicine hospital, 3 general hospitals and 12 community health centers.The survey includes pharmacy area, TCM sales, TCM species, rules and regulations, staffing and so on.Results The amount of TCM in Jiading district public medical institutions met the demand, but pharmacy area did not meet the state standard.Pharmacy-related regulations were not sound.Decocting of TCM lacked supervision.Continuing education content needs to be updated.Conclusion Pharmaceutical management of TCM in Jiading district has room for improvement.Corrective actions in accordance with the relevant provisions are recommended.

A comparative study on the clinical effects of 1470 nm diode laser vaporization and transurethral resection of the prostate for benign prostatic hyperplasia / 中国综合临床

Objective To compare the safety and efficacy of 1 470 nm diode laser vaporization of the prostate with transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH).Methods From July 2014 to July 2015,82 patients diagnosed as BPH were randomly divided into two groups.Forty cases of them underwent 1 470 nm diode laser vaporization and 42 cases for TURP.The operation time,hemoglobin decrease,serum sodium decrease,bladder irrigation time,duration of bladder catheterization and postoperative complications were recorded.The international prostate symptom score (IPSS),maximum flow rate (Qmax) and post-voiding residual volume (PVR) before and after operation were compared.Results No differences were found between the two groups in basic preoperative characteristics,such as:age,prostate volume,IPSS,PVR and Qmax(P＞0.05).The mean operative time in the diode laser group was (64.8±14.6) min,slightly longer than tin he TURP group ((59.3 ± 14.5) min,P＞0.05).The hemoglobin decrease,the serum sodium decrease,the time of bladder irrigating and the time of catheterization of 1470 nm diode laser group were all less than that in TURP group,the differences were significant between the two groups((2.06±1.43) g/L vs.(6.07±1.68) g/L,(1.16±0.67) mmol/L vs.(4.09±3.78) mmol/L,(5.08±2.80) h vs.(25.8±12.7) h,(3.38±1.17) d vs.(4.88± 1.42) d,respectively;t =-11.615,-4.845,-10.337,-5.232;P＜0.001).The complications in 1470nm diode laser group were less than that in TURP group,but the differences were not significant between the two groups(P＞0.05).All patients were followed up for 3-12 months,the IPSS,PVR and Qmax of 3 months after surgery in 1 470 nm diode laser group and TURP group were all improved significantly compared with that of preoperative in both groups,but no statistical differences could be found between the two groups(IPSS:F inner grouP=527.65,P＜0.001;F between groups=0.099,P=0.753;F across groups=0.040,P=0.843,PVR:F inner grouP =509.57,P＜ 0.001;F between groups =2.817,P =0.097;F across groups =1.02,P=0.315;Qmax:inner grouP=60.06,P＜0.001;F between groups =0.30,P=0.585;F across groups =0.394,P=0.532).Conclusion 1 470 nm diode laser vaporization of the prostate can significantly improve the patient's lower urinary tract obstruction symptoms,which show similar short-term effects with TURP.It also has advantages of less bleeding,shorter catheter indwelling time and rapid postoperative recovery compared with TURP,suggesting that it is a safe and effective operation for BPH treatment.

MiR-126 expression relationship with VEGF in breast cancer and its anti-tumor effect / 中国免疫学杂志

Objective:To probe the expression of miR-126 and VEGF in breast cancer, and the anti-tumor effect of miR-126. Methods:The expression of miR-126 and VEGF in breast cancer tissues and cells were detected by qRT-PCR and Western blot;after transfection with miR-126 mimics into MDA-MB-231,expression of VEGF was detected again,MTT assay and cell scratch test were used to verify the influence of miR-126 on proliferation and migration of tumor cells. Results: The expression of miR-126 was lower in the breast cancer tissues and cells,the expression of VEGF was negative correlation with it,increasing the expression of miR-126 may decrease the expression of VEGF and inhibit the proliferation and migration of breast cancer cells. Conclusion:miR-126 can reduce the proliferation and migration of breast cancer cells by inhibiting the expression of VEGF,which play an anti-tumor effect.

Clinical analysis of efficacy and quality of life of segmental bowel resection for bowel endometriosis / 中华妇产科杂志

Objective To evaluate the efficacy and quality of life of segmental bowel resection for bowel endometriosis. Methods Totally 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection were recruited. A visual analogue scale (VAS) and the 36-item short form health survey (SF-36) questionnaire were administered before and at least 1 year after surgery, respectively. Pregnancy rates were also recorded. Results Sixty-two patients in total underwent follow-up ranging from 12 to 74 months. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, pain on defecation and chronic pelvic pain. The relief of dysmenorrhea (2.9 ± 2.2 versus 7.5 ± 2.9), dyspareunia (0.7 ± 0.5 versus 4.3 ± 2.2) and pain on defecation (1.6 ± 0.7 versus 7.3 ± 1.9) after surgery was statistically significant (all P<0.01). The scores for all 8 domains of the SF-36 questionnaire were significant improved after segmental bowel resection (all P<0.01). The complication rate was 45% (28/62), including 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, pelvic abscess and general peritonitis. All of the patients with complications recovered well throughout follow-up. The postoperative pregnancy rate of the previous infertile patients was 6/10. Among the 6 gestational cases, 2 had labour, 2 underwent caesarean sections, one had a spontaneous natural abortion, and one underwent uterine curettage. Conclusion Segmental bowel resection could significantly relieve pain and improve quality of life for patients with bowel endometriosis.

Clinical study of rociverine tablets combined with Suoquan capsules in the treatment of female patients with overactive bladder syndrome / 中国基层医药

Objective To assess the efficacy and safety of combining rociverine tablets with Suoquan cap-sules in the treatment of female patients with overactive bladder(OAB).Methods 152 female patients with OAB were randomly divided into three groups.Patients in rociverine group were administered rociverine tablets 10mg three times a day for 4 weeks.Patients in Suoquan capsule group were administered Suoquan capsules 1.8g three times a day for 4 weeks.Patients in combination group were administered rociverine tablets 10mg and Suoquan capsule 1.8g three times a day for 4 weeks.Each group of patients had to complete 3d voiding diary before and after treatment to record daily frequency of micturition,urgency,urgency incontinence,nocturia and avoiding volumes,OABSS score and drug side effects were also observed.All the data were analyzed to assess the efficacy and safety of treatment.Results There were significant differences in daily frequency of micturition,urgency,urgency incontinence,nocturia,avoiding volumes and OABSS score of patients in each group before and after treatment(all P 0.05).The incidence rates of adverse events of rociverine and combination group were 7.8% and 22.6%,respectively,there was significant difference between the two groups(χ2 =4.372,P =0.032). Conclusion Combining rociverine tablets with Suoquan capsules in the treatment of female patients with OAB was effective and safe.

Correlation of Clinical Efficacy of XPD Gene Polymorphisms and Platinum-based Chemotherapy in Ad-vanced Non-small Cell Lung Cancer:A Meta-analysis / 中国药房

OBJECTIVE:To systematically review the relationship of clinical efficacy between XPD Lys751Gln (A/C),XPD Asp312Asn(G/A)and platinum-based chemotherapy in patients with advanced non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed, Cochrane Library, EMBase, Medline, CJFD,VIP database and WanFang database,studies about the effects of XPD Lys751Gln and XPD Asp312Asn polymorphism on ef-fectiveness,clinical outcomes and adverse drug reaction of platinum-based chemotherapy in advanced NSCLC patients were collect-ed,and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS:Totally 30 studies were included,involving 5 028 patients. Genetic testing showed that XPD Lys751Gln divided into mutant gene (Lys/Gln + Gln/ Gln) and wild-type gene (Lys/Lys),while XPD Asp312Asn divided into mutant gene (Asp/Asn + Asn/Asn) and wild-type gene (Asp/Asp). Results of Me-ta-analysis showed,the progression-free survival (PFS) of Lys/Gln+Gln/Gln patients with platinum in XPD Lys751Gln polymor-phism was obviously lower than Lys/Lys patients [OR=-1.12,95%CI(-1.73,-0.50),P<0.001],while there was no significant difference in the chemotherapy effectiveness and total survival period. The effective rate of Asp/Asn+Asn/Asn patients for platinum in XPD Asp312Asn polymorphism was lower than Asp/Asp patients [OR=0.80,95%CI(0.68,0.96),P=0.02],while there was no significant difference in the total survival period and PFS. Meanwhile,the incidence of Ⅲ-Ⅳ level gastrointestinal adverse reac-tions of Lys/Gln+Gln/Gln with platinum in XPD Lys751Gln polymorphism was higher than Lys/Lys patients [OR=0.43,95%CI (0.20,0.94),P=0.03],and there was no significant difference in Ⅲ-Ⅳ level blood system adverse reactions. CONCLUSIONS:XPD Lys751Gln polymorphism may be associated with PFS and Ⅲ-Ⅳ level gastrointestinal adverse reactions for advanced NSCLC patients with platinum-based chemotherapy,while XPD Asp312Asn polymorphism may have effect on platinum-based chemotherapy,both of them may be as estimate the chemotherapy effect and prognosis detection index of platinum-based chemo-therapy.

Inhibitory effect of lycium barbarum polysaccharide on bleomycin-induced pulmonary fibrosis in mice and its mechanisms / 医学研究生学报

Objective Pulmonary fibrosis ( PF) is a group of pulmonary interstitial pathological changes caused by various factors, and its pathogenesis is not yet fully elucidated .This article discussed the effect of lycium barbarum polysaccharide ( LBP) on ble-omycin-induced PF in mice and its action mechanisms . Methods The C57/BL6 mice were randomly divided into 6 groups:sham-opera-tion, PF model, dexamethasone ( DM), high-dose LBP, medium-dose LBP, and low-dose LBP.The mice in the sham-operation group were injected into the trachea with isotonic saline and those in the oth-er groups with 5 bleomycin at mg/kg for establishing the PF model . Two days after modeling , the mice in the DM and high-, medium-,and low-dose LBP groups were treated with DM at 5 mg/kg and LBP at 0.8, 0.4, and 0.2 g/kg, while those in the sham-operation and PF model groups with the same volume of isotonic saline , respectively , qd, for 4 consecutive weeks .Then, the pathological chan-ges of the lung tissue were observed and the hydroxyproline ( HYP) content in the lung tissue was detected for all the animals .RT-PCR was used to determine the relative expressions of the PF-related COL1A1 and α-SMA genes. Results Compared with the PF mod-els, the the high-, medium-, and low-dose LBP groups showed significant increased body weight after 4 weeks of medication ([14.29 ±0.38] vs [16.12 ±0.37], [15.58 ±0.25] and [15.07 ±0.21] g, P<0.01), the high-and medium-dose groups ex-hibited remarkably decreased lung indexes ([0.887 ±0.13] vs [0.847 ±0.22] and [0.859 ±0.18]%, P<0.05), and the high-dose group presented markedly reduced alveolitis score (3.40 ±0.23 vs 3.09 ±0.22, P<0.05), PF score (3.57 ±0.27 vs 3.07 ± 0.31, P<0.01) and HYP content ([0.831 ±0.05] vs [0.786 ±0.07] μg/mg wet weight, P<0.05).In comparison with the mod-el group, the DM, high-dose LBP and medium-dose LBP groups showed significantly decreased gene expressions of COL 1A1 (1.53 ± 0.13 vs 1.26 ±0.10 and 0.98 ±0.17, P<0.05) and α-SMA (5.67 ±0.47 vs 4.19 ±0.28 and 2.29 ±0.31, P<0.05). Conclusion LBP can suppress the progression of bleomycin-induced pulmonary fibrosis by inhibiting the gene expressions of COL 1A1 andα-SMA and decreasing the HYP content in the lung tissue .

Comparison of the clinical effect of different delivery mode of the re-pregnancy after cesarean section / 中国基层医药

Objective To observe and research the influence of vaginal delivery and cesarean section by two kinds of mode of delivery on maternal infant outcome of re-pregnancy after cesarean section.Methods 258 patients with re-pregnancy after cesarean section were selected,they were divided into vaginal delivery group(73 cases) and cesarean section group(185 cases) according to the different delivery mode.The maternal puerperal infection rate,24h postpartum hemorrhage volume,days,cost of hospitalization,lochia time and neonatal in hospital of both two groups were compared.Results The success rate of vaginal delivery was 69.52％,the rate of cesarean section was 71.71％.In vaginal delivery group,maternal puerperal infection rate,24 h postpartum hemorrhage volume,length of hospital stay,cost of hospitalization,lochia time were 1.73 ％,(201.54 ± 107.54) mL,(3.41 ± 0.09) d,(1 540.12 ±117.21),(21.36 ± 13.12) d,which were significantly better than the second cesarean section group [8.11％,(354.64 ± 215.54) mL,(7.45 ± 0.32) d,(4 932.62 ± 786.35),(27.11 ± 17.04) d],the differences were statistically significant (x2 =4.08,t =4.75,7.24,8.91,3.98,all P ＜ 0.05).Delivery of two kinds of mode of delivery of the newborn had no significant differences in birth weight,Apgar score,the rate of infection,intracranial hemorrhage rate and the asphyxia rate(t =0.15,0.09,0.46,0.00,x2 =0.03,all P＞0.05).Conclusion Re-pregnancy after cesarean section is not the choice of cesarean section delivery clinical indications of operation,when the pregnant women with indications of trial production,in strict monitoring downlink vaginal delivery.

Safety investigation of cytokine induced killer cell therapy in patients with malignant tumor / 中国免疫学杂志

Objective:To observe the adverse reactions of killer cytokine-induced (CIK) in the treatment of malignant tumor and to analyze the possible mechanism ,and to develop the targeted prevention and treatment measures .Methods: The clinical data, including various adverse reactions , laboratory tests and the corresponding preventive measures against adverse reactions .In 1 240 patients with malignant tumor after treated with CIK cells from May 2013 to September 2015 were retrospectively analyzed .Results:The main adverse reactions after the first infusion of CIK cells were weak (10%),fever(7.25%),shiver (4%),arthralgia (3%),systemic in flammatory response syndrome reaction ( 3%) , digestive tract discomfort ( 0.96%) , acute allergic reaction ( 0.08%) , rash (0.08%),angina pectoris (0.08%),tumor lysis syndrome(0%),infection(0%).With the increase of the treatment ,the incidence of adverse reactions increased and the fever was the main performance ,after the fourth course into the platform .The combination of blood pressure increased or decreased and severe allergic reaction and systemic inflammatory response syndrome was needed to be treated .The CIK cells were pretreated before treatment could reduce the incidence of these reactions .Conclusion:CIK cells therapy is a safe and effective adoptive immunotherapy for malignant tumor and its adverse reactions can be treated expectantly , but rare adverse reactions may have potential risks .

Investigation on prescription dosage of TCM decoction pieces / 药学实践杂志

Objective To find out the status of the prescription dosage of TCM decoction pieces in Jiading Hospital of Traditional Chinese Medicine(TCM) .Methods 1 000 prescriptions in 2013 were extracted ,frequency ,number of drug over-dosed ,dosage of poisonous TCM decoction pieces were analyzed .Results The total dose more than 300 grams of prescriptions accounted for 59.6% .The top 10 utility frequency of medicine were Glycyrrhizae radix et rhizoma ,Astragali radix ,Atractyl-odismacrocephalaerhizoma,Poria,Angelicaesinensisradix,Salviaemiltiorrhizaeradixetrhizoma,Paeoniaeradixalba, Coicis semen ,Eucommiae cortex ,Citri Reticulatae pericarpium ,which had varying degrees of overdose .Poisonous TCM de-coction pieces was also overdosed .Conclusion The issues of Chinese herbal medicine prescription was serious ,which need to be improved to ensure rational prescription drug safety .