Study on anatomical parameters of adult lumbar intervertebral disc and endplate based on CT / 中国骨伤

OBJECTIVE@#To provide basic data for clinical application and individualized design of lumbar disc prostheses by measuring the anatomical parameters of lumbar intervertebral discs and endplates in healthy adults with CT three-dimensional reconstruction technology.@*METHODS@#A retrospective analysis was performed on 200 males and 200 females with normal lumbar spine who were admitted to the imaging center or outpatient department of the Second Affiliated Hospital of Xinjiang Medical University from September 2019 to December 2020. The age ranged from 20 to 60 years old, with an average of (40.61±11.22) years old. The measurement segment was L1-S1 intervertebral disc, and the measurement indicators included the axial anteroposterior diameter and transverse diameter of the intervertebral disc, sagittal anterior, middle and posterior height, coronal left and right height, intervertebral space angle, and transverse and anteroposterior diameters of the upper and lower endplates of each vertebral body.@*RESULTS@#①In terms of gender, the anatomical parameters of L1-S1 disc axial diameter, transverse diameter, sagittal anterior, middle and posterior height, left and right coronal height and intervertebral space angle were all higher in males than in females(P<0.05), and the anatomical parameters of upper and lower endplates of L1-S1 vertebral body were higher in males than in females(P<0.001). ②In comparison of sagittal height of anterior, middle and posterior intervertebral discs, the sagittal height of L1-L5 intervertebral discs was middle-high > anterior-high > posterior-high(P<0.001), while that of L5S1 intervertebral disc was anterior-high > middle-high > posterior-high (P<0.001). ③In the comparison of left and right coronal height, there was no statistical significance in the left and right coronal height of L1-S1 disc between male and female(P>0.05). ④The L1-S1 intervertebral spaces angle between male and female increased with the increase of vertebral body segments. ⑤The anterior and posterior diameters and transverse diameters of upper and lower of L1-S1 vertebral bodies endplates were height in males than in females(P<0.001).@*CONCLUSION@#The results suggest that gender differences should be considered in the design of adult lumbar disc prostheses. The anatomical parameters of the lumbar intervertebral disc varied with the increase of the vertebral body sequence, suggesting that different anatomical parameters of the intervertebral disc should be considered in the design of the artificial intervertebral disc, and the changes in the height of the sagittal position suggest that the design of the intervertebral disc should be wedge-shaped.

Mechanism of Baihe Dihuangtang in Treatment of Depression with Yin Deficiency and Internal Heat / 中国实验方剂学杂志

ObjectiveTo establish a traditional Chinese medicine （TCM） syndrome model with yin deficiency and internal heat， discuss the rationality of model evaluation， and analyze differentially expressed genes in multiple dimensions to explore the molecular mechanism-signaling pathways as well as key targets of Baihe Dihuangtang （BHDH） in treating depression with Yin deficiency and internal heat. MethodForty male SD rats were randomly divided into a blank control group，a model group，a fluoxetine group （positive drug），a BHDH group， and a Zhibai Dihuangtang group （positive drug for Yin deficiency and internal heat）. The depression model with Yin deficiency and internal heat was induced by chronic unpredictable mild stress （CUMS）combined with Chinese herbal drugs with warm and heat nature. The model established was comprehensively evaluated by the detection of the basic condition， behavioral performance， and biochemical indicators of rats in each group. The differentially expressed genes were screened out by mRNA sequencing and underwent Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analyses. The protein-protein interaction （PPI） network was plotted and key genes were analyzed to explore the underlying mechanism of BHDH in treating depression with Yin deficiency and internal heat. ResultThe comparison of basic conditions， behavioral assays， energy metabolism， endocrine hormones， cytokines， and neurotransmitters showed that the model was properly induced. BHDH could significantly improve depression with Yin deficiency and internal heat by regulating the pathways related to the nervous system， endocrine system， and inflammatory and immune system. The key genes of the PPI network were Fos， Epha8， Npy2r， Htr2c， and Nr4a1. ConclusionUnder the guidance of TCM theories of treatment based on syndrome differentiation and etiology and pathogenesis，this study established a depression model with yin deficiency and internal heat in animals and evaluation system in accordance with the symptoms and signs of emotional diseases， and further confirmed the scientificity of the modeling method and the underlying mechanism of BHDH in interfering with depression with Yin deficiency and internal heat based on the results of mRNA sequencing.

Intravenous Immunoglobulin to Suppress Progression in a Patient With Advanced Breast Cancer / 한국유방암학회지

Intravenous immunoglobulin (IVIG) is used to treat various diseases and has anticancer effects that suppress metastases in animal models of sarcoma and melanoma. However, these effects have been observed in a limited number of clinical cases. We report the case of a patient with metastatic breast cancer in which long-term IVIG treatment stopped disease progression in the absence of salvage chemotherapy. The patient was treated with IVIG for the treatment of immune thrombocytopenia. Surprisingly, the lung and brain metastases were stabilized, and the patient achieved a progression-free interval of 29 months. More cases are needed to investigate and confirm the efficacy of IVIG in solid tumors in the future.

Liver quality standards and donor scoring system for citizen organ donation after death / 中华普通外科杂志

Objective:To establish donor liver quality related risk factors for the loss of function of transplanted liver.Methods:The data of donors and recipients of liver transplantation at the Organ Donation and Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University from Nov 2011 to Dec 2018 were analyzed retrospectively. Propensity score matching (PSM) was performed to evaluate and screen the data of donors and recipients, in order to balance the covariates.Results:Of the organ donation, there were 70 males and 20 females , aging (40.6±16.3) years. Of the liver transplantation recipients, there were 70 males and 20 females , aging (41.8±20.3) years. Liver dysfunction after transplantation was significantly correlated with the following variables: the donor's CPR time( t=0.429, P=0.000), 15-minute retention rate of indocyanine green ( χ2=67.151, P=0.000), liver function grading ( χ2=54.154, P=0.000), bullae fatty liver grading ( χ2=8.120, P=0.017), vesicular fatty liver grading ( χ2=16.000, P=0.001), ICU stay time ( χ2=14.900, P=0.001)and serum creatinine level ( χ2=44.685, P=0.000). The donor scoring system was established in our studying. For the 90 organ donation cases, the donated liver quality were classified into four levels,which were of good correspondence to the prognosis of the recipients. Conclusion:This donor scoring system and grading standards established by analyzing the high-risk factors of liver dysfunction after transplantation helps evaluate the quality of donor liver in China.

A long-term ischemic stroke risk score model in patients aged 60 years and older with obstructive sleep apnea: a multicenter prospective cohort study / 南方医科大学学报

OBJECTIVE@#To analyze the independent risk factors of long-term ischemic stroke and establish a nomogram for predicting the long-term risks in elderly patients with obstructive sleep apnea (OSA).@*METHODS@#This multicenter prospective cohort study was conducted from January, 2015 to October, 2017 among consecutive elderly patients (≥60 years) with newly diagnosed OSA without a history of cardio-cerebrovascular diseases and loss of important clinical indicators. The follow-up outcome was the occurrence of ischemic stroke. The baseline demographic and clinical data, sleep parameters, laboratory and ultrasound results were collected from all the patients, who were randomized into the modeling group (n=856) and validation group (n=258) at a 3∶1 ratio. LASSO regression was used for variable reduction and dimension screening, and the risk score prediction model of ischemic stroke was established based on Cox proportional hazard regression.@*RESULTS@#In the total of 1141 patients enrolled in this study, 58 (5.08%) patients experienced ischemic stroke during the median follow-up of 42 months (range 41-54 months). The cumulative incidence of ischemic stroke was 5.14% in the model group and 4.91% in the verification group (P < 0.05). Age (HR=3.44, 95% CI: 2.38- 7.77), fasting blood glucose (FPG) (HR=2.13, 95% CI: 1.22-3.72), internal diameter of the ascending aorta (HR=2.60, 95% CI: 1.0- 4.47), left atrial anteroposterior diameter (HR=1.98, 95% CI: 1.75-2.25) and minimum oxygen saturation (LSpO2) (HR=1.57, 95% CI: 1.20-1.93) were identified as independent risk factors for ischemic stroke (P < 0.05 or 0.01). A long-term ischemic stroke risk score model was constructed based the regression coefficient ratios of these 5 risk variables. Before and after the application of the Bootstrap method, the AUC of the cohort risk score model was 0.84 (95% CI: 0.78- 0.90) and 0.85 (95% CI: 0.78- 0.89) in the model group and was 0.83 (95% CI: 0.73-0.93) and 0.82 (95%CI: 0.72-0.90) in the verification group, respectively, suggesting a good prediction efficiency and high robustness of the model. At the best clinical cutoff point, the cumulative incidence of ischemic stroke was significantly higher in the high-risk group than in the low-risk group (P=0.021).@*CONCLUSION@#This model can help to identify high-risk OSA patients for early interventions of the risks of ischemic stroke associated with OSA.

Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Australian Institution’s Experience

Purpose@#We report outcomes and evaluate patient factors and the impact of surgical evolution on outcomes in consecutive ulcerative colitis patients who had restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) at an Australian institution over 26 years. @*Methods@#Data including clinical characteristics, preoperative medical therapy, and surgical outcomes were collected. We divided eligible patients into 3 period arms (period 1, 1990 to 1999; period 2, 2000 to 2009; period 3, 2010 to 2016). Outcomes of interest were IPAA leak and pouch failure. @*Results@#A total of 212 patients were included. Median follow-up was 50 (interquartile range, 17 to 120) months. Rates of early and late complications were 34.9% and 52.0%, respectively. Early complications included wound infection (9.4%), pelvic sepsis (8.0%), and small bowel obstruction (6.6%) while late complications included small bowel obstruction (18.9%), anal stenosis (16.8%), and pouch fistula (13.3%). Overall, IPAA leak rate was 6.1% and pouch failure rate was 4.8%. Eighty-three patients (42.3%) experienced pouchitis. Over time, we observed an increase in patient exposure to thiopurine (P=0.0025), cyclosporin (P=0.0002), and anti-tumor necrosis factor (P<0.00001) coupled with a shift to laparoscopic technique (P<0.00001), stapled IPAA (P<0.00001), J pouch configuration (P<0.00001), a modified 2-stage procedure (P=0.00012), and a decline in defunctioning ileostomy rate at time of IPAA (P=0.00002). Apart from pouchitis, there was no significant difference in surgical and chronic inflammatory pouch outcomes with time. @*Conclusion@#Despite greater patient exposure to immunomodulatory and biologic therapy before surgery coupled with a significant change in surgical techniques, surgical and chronic inflammatory pouch outcome rates have remained stable.

Efficacy and safety of stress ulcer prophylaxis in septic patients: a retrospective cohort study based on large database / 中华危重病急救医学

Objective:To evaluate the effects and safety of stress ulcer prophylaxis (SUP) versus no prophylaxis in adult septic patients at risk of gastrointestinal bleeding (GIB).Methods:A retrospective cohort study was conducted, the data was extracted from Electronic Intensive Care Unit-Collaborative Research Database (eICU-CRD). All patients who received proton pump inhibitor (PPI) or H 2 receptor antagonist (H 2RA) or combined/sequential use for SUP within the first 48 hours of intensive care unit (ICU) admission were enrolled in the SUP group, those who did not received any SUP were enrolled in the non-SUP group. The differences of in-hospital mortality, length of ICU stay (LOS), the incidence of GIB and secondary infection complications between the two groups were compared. Propensity score matching (PSM) was conducted to balance the distributions of study variables between the two groups. Further subgroup analysis was performed according to whether SUP was used for more than 3 days. Multivariate Logistic regression analysis was conducted to analyze the factors influencing the outcome of GIB and secondary pneumonia. Results:A total of 11 413 patients were included in the final analysis, with 9 799 patients in SUP group and 1 614 in non-SUP group. A 1∶1 PSM created 1 600 patients in each cohort. ① Baseline characteristics: compared with SUP group, patients in non-SUP group were older [years old: 69.0 (56.0, 80.0) vs. 67.0 (56.0, 78.0)], acute physiology and chronic health evaluation Ⅳ (APACHEⅣ) score and sequential organ failure assessment (SOFA) score were significantly lower [APACHEⅣ score: 65 (50, 73) vs. 72 (58, 87), SOFA score: 5 (4, 7) vs. 7 (5, 9)], higher rates of underlying diseases such as hypertension and diabetes [hypertension: 15.6% (252/1 614) vs. 12.2% (1 196/9 779), diabetes: 4.5% (72/1 614) vs. 3.3% (325/9 779), both P < 0.05], indicating that patients in the SUP group were more severe. ② Comparison of clinical outcome: before PSM, SUP group had significantly higher in-hospital mortality [17.2% (1 688/9 799) vs. 10.9% (176/1 614)], longer LOS [days: 4.4 (2.9, 7.7) vs. 3.1 (2.5, 4.3)], and higher incidence of secondary pneumonia than non-SUP group [11.3% (1 112/9 799) vs. 6.8% (110/1 614)], with significant differences (all P < 0.05). There was no significant difference in the incidence of GIB and Clostridium difficile infection (CDI) between the two groups. After PSM, no significant differences were observed between the two groups with regard to in-hospital mortality, incidence of GIB and CDI. However, the SUP group had longer LOS [days: 3.9 (2.8, 6.6) vs. 3.1 (2.5, 4.3)], and higher incidence of secondary pneumonia [10.9% (174/1 600) vs. 6.8% (108/1 600)] compared with non-SUP group, the differences were statistically significant (all P < 0.05). Subgroup analysis showed that compared with SUP < 3 days group, patients in SUP ≥ 3 days group had higher disease severity score [APACHEⅣ score: 66 (51, 79) vs. 62 (48, 72), SOFA score: 6 (4, 8) vs. 5 (4, 7), both P < 0.05], in addition, patients in SUP≥3 days group had higher in-hospital mortality, incidence of GIB and secondary pneumonia (16.4% vs. 10.7%, 6.1% vs. 1.8%, 19.0% vs. 8.6%, respectively), and longer ICU LOS [days: 6.6 (4.1, 11.8) vs. 3.5 (2.6, 5.3), all P < 0.05]. ③ Multivariate Logistic regression analysis showed that SUP≥3 days group was associated with more GIB than that of non-SUP group [odds ratio ( OR) = 1.84, 95% confidence interval (95% CI) was 1.07-3.08, P = 0.030], and the incidence of GIB was less in SUP < 3 days group than that of non-SUP group ( OR = 0.57, 95% CI was 0.34-0.94, P = 0.020). When compared with non-SUP group, the risk of secondary pneumonia was increased both in SUP≥ 3 days group and SUP < 3 days group ( OR values were 2.95 and 1.34, 95% CI were 2.10-4.13 and 1.01-1.77, P values were < 0.001 and 0.040, respectively). Conclusion:Among critically ill adult patients with sepsis at risk for GIB, SUP showed no effect on reducing in-hospital mortality, the rate of GIB and CDI, but was associated with increased risk of secondary pneumonia and prolonged LOS.

Fast Separation Method of Continuous Recording Data in Dynamic Electrocardiogram Database / 中国医疗器械杂志

The square waves and pulses with obvious porter characteristics are inserted into each different adjacent existing dynamic electrocardiogram data to solve the time-consuming problem in the currently used manual input verification method. The standard database files are converted into analog siginals, then output automatically to the ECG acquisition device according to the sequence of the database files in one time. The data recorded in the acquisition equipment is separated according to the interval data protocol, so as to achieve the purpose of rapid digital examination of dynamic electrocardiogram.

Rescue of male infertility through correcting a genetic mutation causing meiotic arrest in spermatogonial stem cells / 亚洲男科学杂志(英文版)

Azoospermia patients who carry a monogenetic mutation that causes meiotic arrest may have their biological child through genetic correction in spermatogonial stem cells (SSCs). However, such therapy for infertility has not been experimentally investigated yet. In this study, a mouse model with an X-linked testis-expressed 11 (TEX11) mutation (Tex11

Wiltse approach combined with contralateral transforaminal lumbar interbody fusion and conventional surgery for lumbar disc herniation:a case-control study / 中国骨伤

OBJECTIVE@#To compare the clinical effecty of Wiltse approach combined with contralateral transforaminal lumbar interbody fusion (TLIF) and traditional TLIF in the treatment of lumbar disc herniation and its affect on injury of multifidus muscle.@*METHODS@#From June 2014 to September 2017, 90 patients with lumbar disc herniation combined with lumbar spine instability were divided into two groups (Wiltse approach group and traditional group) depend on the procedure of operation. Wiltse approach group was treated with Wiltse approach screw placement in one side combined with contralateral TLIF. There were 50 patients in Wiltse approach group, including 36 males and 14 females, aged 45 to 72 yearswith an average of (60.4± 3.1) years. The traditional group was treated with traditional TLIF operation. There were 40 patients in the traditional group, including 25 males and 15 females, aged 45 to 74 years with an average of (62.1±3.4) years. The operative time, intraoperative blood loss, accuracy of screw implantation, postoperative drainage volume and drainage tube removal time were recorded in two groups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI)were observed before and 12 months after operation. All patients underwent CT examination preoperative and 12 months postoperative, and the CT values of bilateral multifidus muscle were measured.@*RESULTS@#All the patients were followed up, 40 patients in traditional group were 12 to 18 months with an average of (15.3±4.3) months; and 50 patients in Wiltse approach group were 13 to 24 months with an average of (16.5± 4.1) months. There were no statistically significant differences in operative time and intraoperative blood loss between two groups (@*CONCLUSION@#Compared with traditional surgical procedures, the Wiltse approach nail placement combined with contralateral TLIF has the advantage of accurate nail placement, reducing multifidus muscle damage, and reducing the incidence of postoperative intractable low back pain.

Medicinal and Edible Resources in Xinjiang： Current Status and Prospects / 中国实验方剂学杂志

The homology of medicine and food has long been recognized in China， and the medicinal and edible resources are often employed to prevent and treat diseases or maintain health in traditional Chinese medicine （TCM）. Due to the unique geographical and climatic conditions， the Xinjiang Uygur Autonomous Region （hereinafter referred to as Xinjiang） is blessed with abundant medicinal and edible resources， like Rosae Rugosae Flos， Punica granatum， and Amygdalus communis， which have been widely used by local ethnic communities as medicine in light of the remarkable pharmacological activities， guaranteeing their health condition to some extent. This paper collected the relevant articles from China National Knowledge Infrastructure （CNKI） database through the keyword and full-text search with the medicinal and edible resource Rosae Rugosae Flos as the search term， and the subsequent analysis revealed that the medicinal and edible resources in Xinjiang has a wide range of applications in food， medicine， and ecological protection. This paper further explored their research value， status， and prospects， so as to provide some references for the rational， effective， and sustainable development and utilization of these medicinal and edible resources in Xinjiang， thus better achieving "poverty alleviation" and "rural revitalization"， popularizing TCM culture， and building a healthy China.

Influence Modified of Shaoyao Gancaotang Combined with Yiguanjian on Chronic Atrophic Gastritis with Deficiency of Stomach Yin / 中国实验方剂学杂志

Objective:To observe clinical effect on chronic atrophic gastritis （CAG） with deficiency of stomach Yin when modified Shaoyao Gancaotang combined with Yiguanjian used on patients， and to study influence to prognostic risk. Method:One hundred and ten cases patients were randomly divided into control group 54 cases and observation group 56 cases. Two groups got treatment of eradication of <italic>Helicobacter pylori </italic>（Hp）. Patients in control group got Yangweishu capsules， 3 grains/time， 2 times/day. Patients in observation groups when Shaoyao Gancaotang combined with Yiguanjian modified， 1 dose/day. The treatment continued for 16 weeks. Before and after treatment， gastroscope was discussed and operative link for gastritis assessment （OLGA） and operative link on intestinal-metaplasia assessment （OLGIM） were recorded， scores of atrophic degree， intestinal metaplasia degree， Hp infection， chronic inflammatory reaction， activity， endoscopic mucosal signs， dyspepsia symptoms， reported outcome patients reported outcomes （PRO） of patients with gastrointestinal diseases were graded. And to test levels of pepsinogenⅠ （PG Ⅰ），PGⅡ， gastrin-17 （G-17）， cytotoxin associated gene A （CagA） and vacuolar cytotoxin （VacA）. Result:The effect of patients treated in observation group was better than the effect of patients received measures in control group （<italic>Z</italic>=2.068， <italic>P</italic><0.05）. Scores of atrophic degree， intestinal metaplasia degree， chronic inflammatory reaction and activity were lower than the scores of patients received measures in control group （<italic>P</italic><0.01）. Levels of OLGA （<italic>Z</italic>=2.037， <italic>P</italic><0.05） and OLGIM （<italic>Z</italic>=2.014， <italic>P</italic><0.05） of patients treated in observation group were better than the levels of patients received measures in control group. And levels of PGⅠ， G-17 and PG Ⅰ/PGⅡ of patients treated in observation group were higher than the dates of patients received measures in control group （<italic>P</italic><0.01）. Positive rates of CagA and VacA were all lower than the dates in control group （<italic>P</italic><0.05）. And gastroscopic mucosal signs and dyspepsia symptoms and scores of PRO were all lower than dates of patients received measures in control group （<italic>P</italic><0.01）. Conclusion:On the basis of eradicating Hp， treatment of Shaoyao Gancaotang with Yiguanjian modified can relieve the clinical symptoms， improve the quality of life of patients， promote mucosal repair， improve the pathological changes， reduce the degree and scope of gastric mucosal atrophy， which is conducive to delay the progression of lesions and reduce the risk of canceration when it used on CAG. It has good clinical efficacy and was worthy of further study

Xinjiang Ethnic Medicines： A Review / 中国实验方剂学杂志

Xinjiang is rich in resources of medicinal plants， which are widely used in ethnic medicines because of their remarkable pharmacological activities and safeguard lives and health of people of all ethnic groups in Xinjiang and local health services. The ethnic medicines in Xinjiang are harmonious but different and united in diversity. Besides， they also promote each other and develop together， constituting an inseparable and important part of traditional Chinese medicine in China. Among them， Uygur medicine， Kazak medicine， Kirgiz medicine， Tajik medicine， and Tatar medicine are predominant in regional characteristics， but the development of the ethnic medicine industry in Xinjiang is backward. In recent years， Xinjiang ethnic medicines have been reported to possess significant pharmacological activities， which deserve further development and investigation. However， the development of ethnic medicines in Xinjiang has been restricted severely due to the lack of effective inheritance of practice and experience， weak basic research， insufficient brand awareness， resource destruction， etc. This study analyzed the medicinal value， development status， and prospects of Xinjiang ethnic medicines and summarized the problems in the modernization of ethnic medicines in Xinjiang to provide some scientific references for the follow-up development and clinical application of Xinjiang ethnic medicines， aiming to promote the sustainable development of traditional ethnic medicines of China.

Mechanism of Chinese Medicine Against Intestinal Mucosal Barrier Injury in Acute Pancreatitis： A Review / 中国实验方剂学杂志

Acute pancreatitis （AP） is one of the most common digestive system diseases in clinic. Its pathogenesis is complex and has not yet been fully clarified. It easily progresses to severe AP if the treatment is not provided in time， and the resulting condition is dangerous with high mortality. Intestinal mucosal barrier （IMB） injury is the key link leading to the aggravation of AP. The IMB injury in the late stage of AP promotes the translocation of harmful intestinal bacteria， the entry of bacteria and the produced endotoxins into blood circulation triggers endotoxemia and enterogenous infection，causing multiple organ failure and even death. Western medicine has limitations in the treatment of IMB injury induced by AP. By contrast， Chinese medicine has been proved effective and reliable in repairing the IMB injury induced by AP through oral administration and external application，and has been widely recognized by physicians and patients. AP falls into the categories of "precordial pain due to spleen disorder"， "thoracic accumulation"， and "pancreas-heat syndrome" in traditional Chinese medicine. The main causes of AP are excessive intake of sweet and greasy food， improper diet， and cholelithiasis， which lead to damp-heat accumulation in the middle energizer， stagnation of spleen and stomach， and obstruction of fu-organ intestine. Therefore， dredging the interior， purging， clearing heat， removing toxin， moving Qi， and activating blood should be emphasized in treatment. According to the related literature both in China and abroad in the past five years， this paper summarized the action mechanisms of Chinese medicine in the treatment of AP-induced IMB injury as follows： It protects the mechanical barrier by improving intestinal microcirculation disorders， relieving intestinal ischemia-reperfusion injury and oxidative stress response， reducing the release of inflammatory mediators and cytokines， and inhibiting the apoptosis of intestinal epithelial cells. It restores the chemical barrier by promoting gastrointestinal functional recovery and shortening enteral nutrition time. It improved the biological barrier by regulating intestinal microecological imbalance. It reinforces the immune barrier by adjusting the level of immune cells. This paper reviewed the characteristics of IMB injury in AP as well as its therapeutic principles and mechanisms with Chinese medicine， aiming to provide a theoretical and scientific basis for the in-depth study and rational application of Chinese medicine for the treatment of IMB injury in AP.

The latest progress on donation after the circulatory determination of death at home and abroad / 器官移植

Organ shortage is a common problem in the field of transplantation worldwide. It is urgent to expand the donor pool via different effective and safe approaches. Recently, "the statement from international collaborative on expanding controlled donation after the circulatory determination of death (cDCDD)" has attracted widespread attention from scholars. The statement aims to promote cDCDD in order to increase organ donation rates, with the ultimate goal of achieving self-sufficiency in transplantation. In this article, the key contents mentioned in the statement were summarized, the terminology update and relevant discussion of donation after the circulatory determination of death (DCDD), the development trend of DCDD, the basic part of the clinical pathway of cDCDD and the key factors affecting the implementation of cDCDD were illustrated, and the inspiration drew from this statement to the sustainable development of organ donation program in China was reflected.

Strategy research and analysis on 10 590 cases of invalid ambulance attendance in prehospital emergency care in Nanshan District of Shenzhen from 2014 to 2018 / 中华危重病急救医学

Objective:To provide a scientific basis for reducing the rate of invalid ambulance attendance and the establishment of grades dispatch system through a retrospective analysis of the invalid ambulance attendance in prehospital emergency care.Methods:The data of the invalid ambulance attendance was collected in Huazhong University of Science and Technology Union Shenzhen Hospital (the only tertiary hospital of in Nanshan District) from 2014 to 2018, and the reasons of the invalid ambulance attendance, the time period during the invalid ambulance attendance occurred (every 3 hours was divided into one time period), and the reasons of ambulance calling were statistically analyzed.Results:① The invalid ambulance attendance rates showed a fluctuating decrease trend year by year from 2014 to 2018, the rates were 31.22% (2 515/8 055), 26.94% (2 147/7 970), 29.80% (2 398/8 046), 25.69% (1 844/7 177) and 21.89% (1 686/7 703), respectively. The total invalid ambulance attendance rate was 27.19% (10 590/38 951) in the five years. ② The top three reasons for the invalid ambulance attendance were cancelled calls, departure before the ambulance arrived, and going to hospital by themselves, accounting for 36.87%, 25.08%, and 17.03%, respectively. The constituent ratios of the causes of invalid ambulance attendance in each year were different with statistical significance (χ 2 = 217.626, P < 0.001). ③ The top three time period of invalid ambulance attendance occurred at 21:00-23:59, 18:00-20:59 and 09:00-11:59, accounting for 16.86%, 14.95% and 13.54%, respectively. There was no statistical significance in the distribution of time period in each year (χ 2 = 32.571, P = 0.252). ④ The top five reasons for ambulance calling of invalid ambulance attendance were fainting/syncope, trauma, alcoholism, traffic accident injuries, and brawls, accounting for 20.13%, 15.67%, 9.97%, 8.64%, and 6.45%, respectively, and there was statistically significant difference in the distribution of the reason for ambulance calls in each year (χ 2 = 194.213, P < 0.001). Conclusion:The invalid ambulance attendance rate is high in Nanshan District of Shenzhen. Improving the professional level and triage ability of the dispatchers, improving the system construction of prehospital emergency care system and increasing social education are conducive to reduce invalid ambulance attendance rate.

Review and prospect of community health service development in Shanghai / 上海预防医学

Since the founding of The People′s Republic of China, with the attention and support of the Party and the Government, the grassroots medical and health service system and service capabilities of our country have been constantly improved, and the people′s physical quality has been enhanced gradually.Especially since the 18th National Congress of the Communist Party of China (CPC) was held, the Party Central Committee has regarded the healthy development of the people as an important part of the governance of the country.The report of the 19th CPC National Congress put "Implementation of a Healthy China Strategy" forward, providing a full range of full-cycle of health services for the population, strengthening the grassroots medical and health service system and the construction of general practitioners, adhering to prevention-oriented, paying equal attention to both Chinese and Western medicine, and promoting the combination of medicine and maintenance, which have put forward new requirements for the development of community health services in our country.On the basis of the actual situation in the development of community health services, Shanghai dares to explore and innovate constantly, and has formed a community health service system with Shanghai characteristics.This paper reviews the development of community health services in Shanghai in the past 50 years, summing up the practical experience and characteristics.

Recent research progress on galectin-3 as a potential therapeutic target in respiratory diseases / 药学学报

Galectin-3 is an endogenous β-galactoside-binding lectin widely distributed in the human body, and it plays an important role in various functions such as cell proliferation, differentiation, apoptosis, cell adhesion, immune response and signal transduction. Accumulating evidence has shown that galectin-3 is involved in the occurrence and development of respiratory diseases, including idiopathic pulmonary fibrosis, lung cancer, pulmonary hypertension and bronchial asthma. This review summarizes and analyzes the research progress on galectin-3 in the above respiratory diseases in order to clarify its role and mechanism, and to provide new ideas for clinical treatment.

Effect of dexmedetomidine on cell apoptosis during lung ischemia-reperfusion injury in a rat model of cardiopulmonary bypass / 中华麻醉学杂志

Objective@#To evaluate the effect of dexmedetomidine on cell apoptosis during lung ischemia-reperfusion (I/R) injury in a rat model of cardiopulmonary bypass (CPB).@*Methods@#Ninety-six SPF healthy adult male Sprague-Dawley rats, weighing 350-500 g, were divided into 4 groups (n=24 each) using a random number table method: sham operation group(group S), CPB group(group C), CPB plus left lung I/R group (group IR), and CPB plus left lung I/R plus dexmedetomidine group (group D). The chest was only opened, and the rats underwent no CPB in group S. Only the CPB model was established in group C. The model of left lung I/R injury was established based on the CPB model in group IR.In group D, the model of CPB plus left pulmonary I/R injury was established, dexmedetomidine was intravenously infused in a dose of 3 μg/kg through the tail vein, followed by a continuous infusion of 1.5 μg·kg-1·h-1 until the end of surgery.Eight rats were selected in each group before operation (T0), at 10 min after opening the left hilum (T1), and at the end of operation (T2), the left lung tissues were taken for examination of pathological changes (with a light microscope) which were scored and for determination of cell apoptosis, and immunohistochemistry score (IHS) was assessed.The apoptosis index was calculated.@*Results@#Compared with group S, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T1, 2 in the other three groups (P<0.05). Compared with group C, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T1, 2 in IR and D groups (P<0.05). Compared with group IR, the pathological changes of lung tissues, IHS and apoptosis index were significantly decreased at T2 in group D (P<0.05).@*Conclusion@#The mechanism by which dexmedetomidine reduces lung I/R injury during CPB is related to inhibiting cell apoptosis in rats.

Effect of dexmedetomidine on cell apoptosis during lung ischemia-reperfusion injury in a rat model of cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effect of dexmedetomidine on cell apoptosis during lung is-chemia-reperfusion(I/R)injury in a rat model of cardiopulmonary bypass(CPB).Methods Ninety-six SPF healthy adult male Sprague-Dawley rats,weighing 350-500 g,were divided into 4 groups(n＝24 each)using a random number table method: sham operation group(group S),CPB group(group C),CPB plus left lung I/R group(group IR),and CPB plus left lung I/R plus dexmedetomidine group(group D).The chest was only opened,and the rats underwent no CPB in group S.Only the CPB model was es-tablished in group C.The model of left lung I/R injury was established based on the CPB model in group IR.In group D,the model of CPB plus left pulmonary I/R injury was established,dexmedetomidine was intrave-nously infused in a dose of 3 μg/kg through the tail vein,followed by a continuous infusion of 1.5 μg?kg-1?h-1 until the end of surgery.Eight rats were selected in each group before operation(T0),at 10 min after opening the left hilum(T1),and at the end of operation(T2),the left lung tissues were taken for examination of pathological changes(with a light microscope)which were scored and for determination of cell apoptosis,and immunohistochemistry score(IHS)was assessed.The apoptosis index was calculated.Results Compared with group S,the pathological changes of lung tissues,IHS and apoptosis index were significantly increased at T1,2 in the other three groups(P＜0.05).Compared with group C,the pathologi-cal changes of lung tissues,IHS and apoptosis index were significantly increased at T1,2 in IR and D groups(P＜0.05).Compared with group IR,the pathological changes of lung tissues,IHS and apoptosis index were significantly decreased at T2 in group D(P＜0.05).Conclusion The mechanism by which dexme-detomidine reduces lung I/R injury during CPB is related to inhibiting cell apoptosis in rats.