The effects of a series of posture intervention strategies guided by ultrasonography during labor process on the parturition with abnormal fetal head position / 中国实用护理杂志

Objective:To explore the clinical effects of a series of posture intervention strategies on correcting abnormal fetal position, so as to provide a basis for Clinical position management and promotion of natural delivery.Methods:This study was a randomized controlled trial. The convenience sampling method was used to select 196 full-term primiparas women with abnormal fetal orientation confirmed by ultrasound as single fetal head position in the Women′s Hospital, School of Medicine, Zhejiang University from March to October 2022 as the research objects. They were divided into control group 106 cases and research group 90 cases by random number table method. The control group received normal nursing and chose comfortable position by themselves during labor. The research group received a series of ultrasound-guided postural intervention strategies for postural management in the first and second stages of labor on the basis of normal nursing. The angle of progression and the midline angle, the fetal orientation, fetal orientation during complete uterine orifice and delivery outcome were compared between the two groups.Results:Finally, 190 cases were included, 105 cases in the control group and 85 cases in the research group. There were 76 vaginal deliveries in the research group and 95 in the control group. The rate of anterior occipital position and the angle of fetal head rotation in the research group were 73.68% (56/76) and 64.55 (37.90, 85.55)°, which were higher than 45.26% (43/95) and 33.00 (14.00, 60.00)° in the control group;the midline angle of the research group was 57.10(38.50, 75.80)°, which was lower than 80.00 (52.50, 90.30)° of the control group. There was significant difference between the two groups ( χ2 = 14.14, Z = 4.17, - 3.74, all P<0.01). The first stage of labor was 522.50 (413.00, 695.00) minutes and the total stage of labor was 611.00 (488.00, 812.00) minutes in the research group, which was lower than 620.00 (450.00, 795.00) and 700.00 (539.00, 904.00) minutes in the control group ( Z = - 2.34, - 2.03, both P<0.05). Conclusions:The application of the serial position intervention strategy under the ultrasound guidance during the labor process can improve the abnormal fetal position, shorten the first stage of labor time effectively and safely, while it does not have any significant effect on the improvement of the delivery outcome.

Comparative analysis of clinical diagnosis and treatment guidelines for drug-induced liver injury at home and abroad / 中华肝脏病杂志

Drug-induced liver injury influencing factors are complex and have diverse clinical manifestations. Simple and reliable diagnostic methods are still deficient, and further classification of toxicological mechanisms is required. There are numerous pertinent discrepancies between domestic and international guidelines aimed at drug-induced liver injury diagnosis and treatment, with partial to no consensus on the content. The American Gastroenterological Association's 2021 Clinical Guidelines, the Asia-Pacific Association for the Study of the Liver's 2021 Consensus Guidelines, the Council for International Organizations of Medical Sciences' 2020 International Consensus, the European Society's Hepatology Committee's 2019 Clinical Practice Guidelines, and the 2015 Chinese Medical Association Guidelines are five influential clinical guidelines on drug-induced liver injury at home and abroad. The epidemiology, risk factors, diagnosis and evaluation, treatment management, and other contents, particularly traditional Chinese medicine, were compared and analyzed using other relevant consensus opinions or guidelines in order to improve understanding and provide a reference for clinical diagnosis and treatment of drug-induced liver injury.

Clinical features of drug-induced liver injury due to / 临床肝胆病杂志

Objective To investigate the clinical features of drug-induced liver injury (DILI) due to Tripterygium wilfordii preparation and concomitant medications in patients with rheumatoid arthritis (RA). Methods A retrospective analysis was performed for the clinical data of 112 RA patients with DILI caused by Tripterygium wilfordii preparations and concomitant medications who were treated in Honghu Hospital of Traditional Chinese Medicine from January 2014 to December 2019, and demographic data and the clinical features of DILI were observed to explore the influence of concomitant medications and underlying diseases on DILI. The Kruskal-Wallis H test was used for comparison of continuous data between multiple groups and further comparison between two groups. Results All 112 patients had a mean age of 48.13±14.38 years, and there were 81 female patients (72.32%). The most common underlying disease was nonalcoholic fatty liver disease (NAFLD) in 8 patients (7.14%), and as for concomitant medications, 70 patients (62.50%) were treated with Tripterygium wilfordii preparation combined with non-steroid anti-inflammatory drug (NSAID) or disease-modifying anti-rheumatic drug (DMARD). The main clinical manifestation was joint pain in 110 patients (98.21%). Among the 112 patients, 102 (91.07%) had abnormal results of liver biochemical examinations; 66 patients (58.93%) had an RUCAM score of 6-8 points, and 110 patients (98.21%) had mild (grade 1) liver injury. After liver-protecting treatment (for less than 6 months in all patients), all patients had an improvement in liver function without aggravation or death. The Tripterygium wilfordii preparation+glucocorticoid+NSAID/DMARD group with 22 patients had significant increases in the serum levels of alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) compared with the Tripterygium wilfordii preparation+NSAID/DMARD group with 70 patients ( P < 0.05). The 8 patients with NAFLD had a significantly greater increase in serum alanine aminotransferase compared with the 90 patients without underlying diseases ( P < 0.05). Conclusion RA patients may develop DILI due to Tripterygium wilfordii preparation and concomitant medications, which is commonly observed in middle-aged women. Joint pain is the main clinical manifestation, and patients tend to have mild liver injury and good prognosis without marked chronicity. More severe liver injury is observed in patients with combined medication of glucocorticoids and NSAID/DMARD or those with the underlying disease of NAFLD.

A preliminary study on the peripheral seroimmunological characteristics of drug-induced liver injury / 临床肝胆病杂志

Objective To investigate the characteristic manifestation of the peripheral seroimmunological indicators such as cellular immunity and cytokines in drug-induced liver injury (DILI). Methods The medical records of 219 patients with DILI collected in Shuguang Hospital and Baoshan Branch from January 2019 to August 2021 were retrospectively analyzed, grouped according to the type of drug injury and the degree of injury, and their clinical characteristics, biochemical and peripheral serum immunological characteristics were analyzed. analyze.Twenty-nine cases were selected from the healthy subjects as the normal liver function group, and 42 cases of DILI cases who had undergone cytokine and cellular immune evaluation within 1 week before the acute onset treatment were confirmed as the DILI control group. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the Fisher test was used to compare the count data between groups. Results Among the 219 DILI patients, 122 (56%) were female and 97 (44 %) were male. 89 cases (40%) of injuries were caused by traditional Chinese medicines, proprietary Chinese medicines or health products, and 130 cases (60%) were caused by western medicines such as anti-tuberculosis and anti-tumor. Among them, 82 cases (37%) were classified as hepatocyte injury type, 17 cases (8%) of cholestatic type, and 120 cases (55%) of mixed injury type. The longest incubation period was 180 days, the shortest was 1 day, and the median was 15 days. Fatigue accounted for 49% of the main symptoms. There were statistically significant differences in cytotoxic T lymphocytes (%) and CD4/CD8 ratio between the traditional Chinese medicine, Chinese patent medicine or health product group and the western medicine group ( Z =2.55 and 3.08, P =0.011 and 0.002, ). From 219 DILI patients, it was confirmed that 42 patients who had detected peripheral immune indicators were compared with 29 patients with normal liver function physical examination. The statistical analysis showed that IL-6 and IL-10 were statistically significant in the peripheral immune serum distribution of DILI. Significance ( Z =3.828 and 2.695, P < 0.001 and 0.007). Conclusion Cytotoxic T lymphocytes may play different roles in the pathogenic mechanisms of Chinese herbal medicines, Chinese patent medicine preparations or health products and western medicines; drugs or drug-protein complexes may affect inflammatory and immune pathways and release related cytokines For example, IL-6 and IL-10 are involved in the pathogenesis of DILI.

Systematic assessment and quality evaluation of literatures on economic evaluation of diabetes drugs in Chinese population / 中国药房

OBJECTIVE To review economic studies of diabetes drugs in Chinese population systematically ，and to provide reference for promoting the development of pharmacoeconomics research in the field of diabetes and improving the research quality. METHODS Retrieving from PubMed ，Embase，SinoMed，CNKI，Wanfang data ，VIP and other databases ，the literatures on economic evaluation of diabetes drugs in Chinese population were collected ；analysis was carried out on the publication ，research content，study design of the literatures. The Consolidated Health Economic Evaluation Reporting Standards 2013（CHEERS 2013） checklist was used for quality evaluation. RESULTS A total of 380 literatures were included ，involving 348 Chinese literatures and 32 English literatures. The first paper of diabetes drugs in Chinese population was published in 2001. The most evaluated drug was metformin. Most of the studies （79.2％）were conducted by medical institutions ，73.9％ of the studies were short-term economic evaluation，and the methods were mainly cost-effectiveness analysis （61.8％），and most of the studies did not reported clear research perspectives （82.6％）. Evaluated by CHEERS 2013，the average score of included literatures was only 10.57，and 85.8％ of the literatures was of unqualified quality. The average score of Chinese literatures was 10.05，that of English literatures was 16.23，and the reporting quality of English literatures was significantly better than that of Chinese literature s（P＜0.001）. CONCLUSIONS The existing literatures on the economic evaluation of diabetes drugs in Chinese population is of low quality. There are problems such as lack of research perspectives ，single research institution/method ，and non-standard reporting. It is recommended that medical institutions ，universities/research institutions ，enterprises，government and other institutions should strengthen cooperation ，improve their research level ，pay attention to more and newer clinically effective treatment regimens ，and promote the transformation of research results into decision-making evidence.

The Establishment and Identification of Acute Myeloid Leukemia NOD-SCID-IL2rg / 中国实验血液学杂志

OBJECTIVE@#To establish the in vivo traceable acute myeloid leukemia mice model with Luciferase-Expressing KG1a Cells.@*METHODS@#KG1a cells with stable luciferase gene expression (called as KG1a-Luc cells) were constructed by lentivirus transfection, then sifted out by puromycin. Eighteen male NOD-SCID-IL2rg@*RESULTS@#KG1a cells expressing luciferase stably were successfully obtained. The tumor luminescence wildly spread at day 17 captured by in vivo imaging. The KG1a-Luc tumor cells could be detected in the peripheral blood of the mice, with the average percentage of (16.27±6.66)%. The morphology and pathology result showed that KG1a-Luc cells infiltrate was detected in bone marrow, spleens and livers. The survival time of the KG1a-Luc mice was notably shorter as compared with those in the control group, the median survival time was 30.5 days (95%CI: 0.008-0.260).@*CONCLUSION@#The acute myeloid leukemia NOD-SCID-IL2rg

Evidence mapping of clinical research on 28 Chinese patent medicines for tension-type headache / 中国中药杂志

In this study, the evidence mapping methodology was used to systematically retrieve and sort out the clinical research evidence of Chinese patent medicines in the treatment of tension-type headache(TTH), and to understand the distribution of evidence in this field and the basis and quality of evidence. Chinese and English articles on the 28 Chinese patent medicines for TTH, which were recorded in National Essential Medicines List(2018), Medicine Catalogue for National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance(2020), and Chinese Pharmacopoeia(2020), were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, China Biology Medicine disc(CBMdisc), PubMed, EMbase, and Cochrane Library from the establishment to June 2021, followed by descriptive analysis. Then, tables and bubble charts were plotted to analyze the distribution characteristics of evidence. A total of 129 eligible articles were yielded: 126 randomized/non-randomized controlled trials, and 3 systematic reviews. The functions, indications, and composition of the 28 medicines, as well as the proportion of related articles, publication trends, intervention measures, and outcome indicators were compared and analyzed. The results showed that the 28 Chinese patent medicines, composed of 128 Chinese medicinals, can be classified into six categories in terms of function: reinforcing healthy Qi, tranquilizing mind, dispelling stasis, regulating Qi, treating wind, and resuscitating. There are ongoing efforts to study the treatment of TTH with Chinese patent medicine in China, despite of little evidence. The clinical positioning of Chinese patent medicine for TTH is not clear, and clinical research fails to highlight the advantages of Chinese medicine. In addition, the outcome indicators have not been standardized and unified, and there is a lack of evidence on the long-term efficacy of Chinese patent medicine for TTH. This study is the first exploratory application of evidence maps to compare the characteristics and clinical research progress of 28 Chinese patent medicines for TTH, which can provide a reference for research on the optimization of Chinese medicine strategies for TTH.

Effect of clotrimazole vaginal tablets combined with lactobacillus vaginal capsules on inflammation and oxidative stress in pregnant women with candidal vaginitis / 中国医师杂志

Objective:The effect of clotrimazole vaginal tablets combined with lactobacilli vaginal capsules on inflammatory response and oxidative stress in pregnant patients with candidal vaginitis.Methods:A prospective study of 126 patients with candidal vaginitis was randomly divided into control group and observation group, 63 cases in each group. The control group received clotrimazole vaginal tablets and the observation group received clotrimazole vaginal tablets combined with lactobacillus vaginal capsule treatment. The efficacy, inflammatory factor levels, oxidative stress and pregnancy outcomes of the two groups were observed.Results:The total clinical effective rate of the observation group was significantly higher than that of the control group (95.24% vs 80.95%, P<0.05). After treatment, the levels of tumor necrosis factor α, interleukin-6, and C-reactive protein inflammatory factors in the observation group were lower than those in the control group. The levels of superoxide dismutase and nitric oxide in the observation group were higher than those in the control group ( P<0.05), and the levels of malondialdehyde and plasma endothelin-1 were lower than those in the control group ( P<0.05). The incidence of premature delivery and premature rupture of membranes in the observation group was significantly lower than that in the control group ( P<0.05). Conclusions:Clotrimazole vaginal tablets combined with lactobacillus vaginal capsules for the treatment of pregnancy with candida vaginitis are effective and can reduce vaginal inflammation, improve oxidative stress, and reduce the occurrence of adverse pregnancy outcomes such as premature delivery and premature rupture of membranes.

Correlation analysis between P73 gene G4C14-to-A4T14 polymorphism and lung cancer risk in Guangdong population / 公共卫生与预防医学

Objective To analyze the correlation between P73 gene G4C14-to-A4T14 double nucleotide polymorphism and the risk of lung cancer in Guangdong population. Methods Genotype analysis of P73 gene polymorphism in peripheral blood of 642 patients with lung cancers (including 450 NSCLC patients and 192 SCLC patients) and 354 normal controls was performed with HRM method (high-resolution fusion curve). Results HRM genotyping results showed that the distribution of P73 genotypes in 450 NSCLC patients was as follows: GC/GC 280 (62.3%), GC/AT 155 (34.4%), and AT/AT 15 (3.3%). P73 genotypes in 192 SCLC patients were 118 GC/GC (61.5%), 67 GC/AT (34.9%) and 7 AT/AT (3.6%). The P73 genotypes of 354 normal controls were 192 GC/GC (53.1%), 136 GC/AT (38.5%), and 26 AT/AT (8.4%). AT/AT homozygous genotypes significantly reduced the risk of NSCLC (OR=0.393；95% CI:0.037-0.873；P=0.001) and SCLC (OR=0.428；95%CI:0.050-0.880；P<0.001) compared with non-carriers. Conclusion The results of the present study indicated that the polymorphism of P73 G4C14-A4T14 may be a modification factor for the susceptibility of lung cancer in Guangdong province, and the increased GC content in the P73 gene may increase the risk of lung cancer.

Liver histopathological features of patients with drug-induced liver injury due to Chinese herbal medicine or Western medicine: A comparative analysis of 50 cases / 临床肝胆病杂志

ObjectiveTo compare the liver histopathological features of drug-induced liver injury (DILI) caused by Chinese herbal medicine (HM) and that caused by Western medicine (WM), and to investigate the pathological features of HM-DILI. MethodsA total of 50 patients with drug-induced liver injury(DILI) who were diagnosed and treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 2014 to June 2019. All the patients with DILI were enrolled and divided into HM-DILI group and WM-DILI group. A retrospective analysis was performed for the clinical features and the pathological features of the two groups, including the clinical type of DILI, severity of liver injury, and liver histopathological features, especially location and grade of liver inflammation, type and degree of steatosis, and iron deposition. The t test and Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups; the Mann-Whitney U test was used for comparison of ranked data. ResultsOf all 50 patients, 20 (40.0%) had HM-DILI and 30 (60%) had WM-DILI. There were no significant differences in sex, age, course of disease, and biochemical parameters of liver function between the two groups (all P＞0.05). The main clinical types of the two groups were hepatocellular injury type and the degree of injury which was mainly grade l, and there were no significant differences in the clinical type of DILI and the severity of liver injury between the two groups (both P＞0.05). As for liver histopathological features, both groups had varying degrees of focal necrosis of hepatocytes, steatosis (microvesicular, macrovesicular, and mixed), and fibrous tissue proliferation at the portal area, and compared with the WM-DILI group, the HM-DILI group had significantly greater lymphocyte/plasma cell infiltration in the portal area (χ2=3.860, P＜0.05) and iron deposition in Kupffer cells (χ2=4787, P＜0.05). ConclusionThere are no significant differences in clinical manifestations between HM-DILI and WM-DILI, but patients with HM-DILI have more obvious inflammation in the portal area and iron deposition in Kupffer cells than those with WM-DILI.

The prognosis of stroke patients with hypertension and its related factors based on a one-year follow-up / 中华老年医学杂志

Objective:To investigate the prognosis and related factors of stroke patients with hypertension after a one-year follow-up, in order to provide evidence for early clinical identification and intervention of high-risk groups.Methods:A total of 719 stroke patients with hypertension who were hospitalized in our hospital from April 2017 to August 2018 were enrolled as the research subjects.General information, history of underlying diseases, family history, drug treatments and laboratory test results were collected.Patients were followed up for 1 year.Patients were divided into the death group and the survival group according to prognosis.Logistic regression analysis was used to identify risk factors for death in stroke patients with hypertension.Results:A total of 77 patients died during the follow-up period, and the mortality rate was 10.7%(77/719). Univariate analysis showed significant differences in marital status( χ2=35.455, P<0.001), education level( χ2=35.238, P<0.001), exercise habits( χ2=10.172, P=0.001), BMI( t=2.161, P=0.031), age( t=-5.976, P<0.001), history of heart disease( χ2=5.064, P=0.024), antiplatelet use( χ2=14.275, P=0.003), antihypertensive drug treatment( χ2=14.597, P<0.001), lipid-lowering drug treatment( χ2=11.311, P=0.001), and creatinine( t=-4.63, P<0.001)between the death group and the survival group.Logistic regression analysis showed that age( OR=1.042, 95% CI: 1.011-1.073), loss of a spouse( OR=3.674, 95% CI: 1.558-8.665), education level( OR=0.418, 95% CI: 0.225-0.779), use of aspirin( OR=0.376, 95% CI: 0.165-0.855), use of clopidogrel( OR=0.451, 95% CI: 0.219-0.928), antihypertensive drug treatment( OR=0.505, 95% CI: 0.282-0.901)and creatinine( OR=1.009, 95% CI: 1.004-1.014)were independent influencing factors for prognosis( P<0.05). Conclusions:The mortality rate is high in stroke patients with hypertension.Advanced age, loss of a spouse and high creatinine level are risk factors for prognosis, whereas high education level, antihypertensive drug treatment and antiplatelet use are protective factors for prognosis.

Value of chemokines levels in predicting the progression of differentiated thyroid carcinoma / 中华核医学与分子影像杂志

Objective:To investigate the relationship between the expression levels of chemokines in serum of patients with differentiated thyroid carcinoma (DTC) and the progression of DTC.Methods:From January to April in 2017, blood samples of 76 patients (25 males, 51 females, median age: 39 years) with DTC after surgery in Nuclear Medicine Department of Tenth People′s Hospital Affiliated to Tongji University were collected retrospectively for detecting the expression levels of 40 chemokines. Patients were divided into different groups according to (1) with or without metastasis: the non-metastasis group ( n=13) and the metastasis group ( n=63); (2) degree of gradual dedifferentiation: without metastasis group ( n=13), lymph node metastasis group ( n=48), highly malignant group ( n=11) and radioactive iodine refractory (RAIR) with distant metastasis group ( n=4); (3) frequency of 131I treatment in follow-up for nearly 2 years: single treatment group ( n=51) and multiple treatment group ( n=25). Differences in chemokine levels among groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of differential chemokines′ levels on DTC metastasis and multiple 131I treatment. Independent-sample t test, Mann-Whitney U test and one-way analysis of variance were used to analyze the data. Results:Compared with the non-metastatic group, the expression levels of Eotaxin-3 ((25.94±6.05) vs (21.76±5.71) ng/L), interferon-γ (IFN-γ; (116.04±28.98) vs (98.71±26.18) ng/L), macrophage-derived chemokine (MDC; (1 468.08±401.74) vs (1 082.94±423.30) ng/L) and thymus expressd chemokine (TECK; (505.22(419.80, 563.36) vs 402.89(347.43, 442.97) ng/L) in metastatic group were decreased, and the differences were statistically significant ( t values: 2.376, 2.131, 3.007, U=215.000, all P<0.05). The area under the ROC curve of IFN-γ+ MDC+ TECK for predicting DTC metastasis was 0.844(95% CI: 0.755-0.932, P<0.001), and the sensitivity was 79.37%(50/63). Only the differences of MDC among without metastasis group, lymph node metastasis group, highly malignant group and RAIR with distant metastasis group were significant ((1 468.08±401.74), (1 121.59±454.20), (976.07±281.04), (922.68±342.41) ng/L; F=3.564, P<0.05), and the expression was gradually decreased with the degree of dedifferentiation. Only IL-8 was significantly increased in the multiple treatment group compared with the single treatment group (28.20(23.22, 32.51) vs 30.51(26.98, 35.57) ng/L; U=801.000, P<0.05). The area under the ROC curve of IL-8 for predicting multiple 131I treatment was 0.648(95% CI: 0.523-0.773, P<0.05), and the sensitivity was 100%(25/25). Conclusions:Decreased expression of IFN-γ, MDC and TECK may be potential markers for predicting metastasis in DTC. MDC is likely to be a potential molecular target for detecting the dedifferentiation degree of DTC, decreased expression of which may indicate the increased malignancy of tumor. IL-8 may be used to predict whether patients need multiple 131I treatments.

Prognosis of fetuses with cystichygroma and nuchal translucency/nuchal fold thickening on prenatal echography / 浙江大学学报·医学版

OBJECTIVE@#To analyze the prognosis of fetuses with cystic hygroma (CH) or nuchal translucency (NT) or nuchal fold (NF) thickening detected by prenatal echography.@*METHODS@#From January 2014 to December 2015, 124 fetuses with CH and NT/NF thickening on prenatal echography were enrolled from Women's Hospital of Zhejiang University School of Medicine. The basic clinical information, ultrasonic results, pregnancy outcomes and newborn follow-ups were analyzed. The cases were grouped by prognosis and the factors affecting prognosis were analyzed with logistic regression.@*RESULTS@#There were 85 cases of labor induction including one stillbirth and 39 cases delivered. Except one infant who died after birth, all live births survived with good prognosis. Univariate analysis showed that the gestational age at diagnosis of poor prognosis group was earlier than that of good prognosis group (<0.01); and the former group also had higher hydrops fetalis rate and additional structural anomalies rate (all <0.01). Multivariate regression analysis showed that hydrops fetalis (=90.105, <0.05) and additional structural anomalies (=61.854, <0.05) were risk factors of poor prognosis in fetuses with CH and NT/NF thickening.@*CONCLUSIONS@#Fetuses with diagnosed CH or NT/NF thickening on prenatal ultrasonography are likely to be associated with chromosomal abnormality. Early gestational weeks, hydrops fetalis and additional structural anomalies may indicate poor prognosis.

Effect of Manual and Machine Decocting on Chemical Constituents in Bazhentang Based on Non-targeted Metabolomics / 中国实验方剂学杂志

Objective: To evaluate the effect of manual decocting and machine decocting on the chemical constituents in Bazhentang based on non-targeted metabolomics, and to find the differential chemical constituents of these two decocting methods. Method: Bazhentang was boiled by standardized manual decocting and machine decocting methods,respectively. Orthogonal partial least square-discriminate analysis(OPLS-DA) and other multivariate statistical methods, combined with variable importance in the projection(VIP) value and t-test, were employed to analyze the effect of two decocting methods on the chemical constituents in Bazhentang. The differential chemical constituents were analyzed by UPLC-LTQ-Orbitrap MS under positive and negative ion modes,mobile phase was acetonitrile-0.1%formic acid aqueous solution for gradient elution,the scanning range was m/z 50-1 500. Result: Under the positive and negative ion modes of high-resolution mass spectrometry, a total of 87 differential components were found,40 of them were identified according to the mass spectrometry data and literature reports, including senkyunolide A, glycyrrhizin, ferulic acid, etc. Conclusion: Based on the analysis of color and chemical compositions of Bazhentang, there are obvious differences between the standardized manual decocting and machine decocting. If the advantages of these two methods are combined,a standardized decoction process can be established on the basis of maintaining the advantages of manual decocting, the effectiveness of traditional Chinese medicine decoction will be maximized and it will be convenient for patients to take it.

Surgical treatment of atypical unstable Hangman fracture in elderly osteoporotic patients / 中国骨伤

OBJECTIVE@#To explore the clinical effect of operative reduction and internal fixation in treating atypical unstable Hangman fracture in elderly osteoporotic patients.@*METHODS@#The clinical data of 9 elderly osteoporotic patients with atypical unstable Hangman fracture treated from December 2012 to December 2017 were retrospectively analyzed. There were 5 males and 4 females with an average age of 72.7 years (range 65 to 79) old. The fracture line was located on bilateral inferior articular surface or lamina with anterior dislocation of axis in 3 cases (similar to Levine-Edwards type II); one side of the fracture line was located on the lower articular surface and opposite side involved on the upper articular surface and the body of axis with atlantoaxial lateral mass dislocation in 4 cases; the fracture line was located at the pedicle of the axis, transverse foramen and posterior inferior wall of the vertebral body, accompanying by anterior and posterior longitudinal ligaments and C₂-C₃ intervertebral disc injury resulted in C₂-C₃ intervertebral instability in 2 cases. According to ASIA grade of spinal cord injury, 2 cases were grade D and 7 cases were grade E. Preoperative JOA scores were 9 to 11 points with an average of 9.8 points. All patients underwent routinely skull traction for reduction. Three patients with anterior dislocation of axis were treated with stage I anterior-posterior internal fixation and 6 patients with simple posterior pedicle screw fixation. Postoperative JOA score, ASIA system and the imaging data were used to evaluate clinical effects.@*RESULTS@#All patients were followed up from 12 to 20 months with an average of 18 months. The neck pain disappeared after operation and cervical spine movement was well in all patients. The improvement rate of JOA at 3 months after operation was 75% to 87.5%. Two cases of ASIA grade D fully recovered to grade E. All fractures healed at 6 to 12 months after operation. Except one case occurred superior laryngeal nerve injury and had a complete recovery after 3 months, the other patients had no complications like spinal cord and vertebral artery injury, plate screw loosening and wound infection.@*CONCLUSIONS@#According to the type of atypical unstable Hangman fracture in elderly osteoporotic patients, choosing a reasonable and personalized surgical plan can achieve immediate cervical stability and well reduction, which is beneficial for early ambulation and quick rehabilitation.

Lipid-lowering effects of oleanolic acid in hyperlipidemic patients / 中国天然药物

Oleanolic acid (OA) is a pentacyclic triterpenoid compound extracted from olea europaeal, a traditional Chinese medicine herb. OA has been used in the clinic as a hepatoprotective medicine in China since 1970s. In our previous study, we observed that OA could ameliorate hyperlipidemia in animal models. In the present study, we conducted a small-scale clinical trial to evaluate the hypolipidemia effect of OA in hyperlipidemic patients. Hyperlipidemic patients were administrated with OA for four weeks (4 tablets once, three times a day). The blood samples of the patients were collected before and after OA treatment. The biological parameters were measured. Furthermore, three patients' blood samples were studied with DNA microarray. After OA administration, the TC, TG, and HDLC levels in serum decreased significantly. DNA microarray analysis results showed that the expressions of 21 mRNAs were significantly changed after OA treatment. Bioinformatics analysis showed 17 mRNAs were up-regulated and 4 mRNAs were down-regulated significantly after OA treatment. Five mRNAs (CACNA1B, FCN, STEAP3, AMPH, and NR6A1) were selected to validate the expression levels by qRT-PCR. Therefore, OA administration differentially regulated the expression of genes involved in lipid metabolism. The data showed a clinical evidence that OA could improve hyperlipidemia and also unveiled a new insight into the molecular mechanisms underlying the pharmacological effect of OA on hyperlipidemia.

Interpreting the Methods for Blending Decoctions to Treat 60 Ailments in Tianhui bamboo slip medical manuscripts / 中国中药杂志

Among the medical texts excavated in 2012-2013 from the Han Dynasty tomb at Tianhui township in Sichuan province, we found a collection on the treatment of 60 ailments. Under each ailment, we found one or more formulas, for a total of 106 formulas. The authors of this paper compiled and analyzed these texts based on the original bamboo slips and named this collection with the title Methods for Blending Decoctions to Treat 60 Ailments because the content was focused on blending and making medicinal formulas, and also due to the historical connections with the texts the Record of the Court Scribe, "Biography of Bian Que and Cang Gong". For these reasons, this title was determined, where "blending decoctions" mean "blending and harmonizing medicines optimally in preparation for decocting". The Tianhui texts preserve ancient forms of medicinal formulas, including some once believed to be lost, such as "grain decoctions", "fermented alcohol decoctions", and "fiery decoctions". Based on the historical evidence, we can now ascertain that this text is the "Blending Formulas and Making Decoctions" mentioned in the Record of the Court Scribe written by Cang Gong. Moreover, the medical texts, Canon Formulas in Decoction Form (from the book of Han Dynasty) and the Imperial Pharmacy Formulas to Benefit the People in Song Dynasty are both of this genre of medical literature. The Tianhui text is therefore a representative of this genre of literature in the Western and eastern Han, acting as a key link between early medical formula books and later formula books.

The effects of two different cold compress modes on swelling and pain among patients receiving extraction of impacted tooth of mandibular / 中国实用护理杂志

Objective To examine the effects of two different cold compress modes (continuous cold compress and intermittent cold compress) on the pain and swelling among patients receiving extraction of impacted tooth of mandibular. Methods From January 2016 to August 2016, 64 cases of adult patients with impacted mandibular impacted wisdom teeth and 24 h in the outpatient department of Oral and Maxillofacial Surgery of Affiliated Stomatological Hospital of Fujian Medical University were selected. They were randomly assigned to the control group and the experimental group (32 cases in each group) by random digital table. The participants in the control group received the usual care plus intermittent cold compress. The participants in the experimental group received the usual care plus continuous cold compress. And the treatment was continued for 24 hours. Outcomes including pain and skin temperature were measured in the intervention cycle, and the swelling was measured at baseline, 6 hour, 12 hours,18 hours, and 24 hours after the intervention. All the participants were asked to have further consultation at 7th days after the operation. Results At 6 hour, 12 hours,18 hours, and 24 hours, the pain of the experimental group was lower than the control group ,and there was significant difference (F=63.665-290.872, P<0.05 ). At 12 hours,18 hours, and 24 hours after the intervention ,number of the swelling grades (0-I-Ⅱ-III) in the control group was 16, 14, 2, 0 cases, 11, 13, 8, 0 cases, 11, 12, 8, 1 cases,number of the swelling grades (0-I-Ⅱ-III) in the experimental group was 27, 5, 0, 0 cases, 26, 6, 0, 0 cases, 26, 6, 0, 0 cases, and there was significant difference (Z=-2.968,-4.017,-4.052, P<0.05). A positive correlation between swelling grade and time (M2=45.22, P<0.05). At 6 hour, 12 hours,18 hours, and 24 hours , the skin temperature of the experimental group was lower than the control group, and there was significant difference (F=1 735.106-23 993.33, P<0.05). Conclusions This study showed that the continuous cold compress was more effective in reducing the pain and swelling among the patients receiving extraction of impacted tooth of mandibular. Compared with the intermittent cold compress, it suggested that continuous cold compress can be integrated into usual care to reduce the pain and swelling among the patients receiving extraction of impacted tooth of mandibular.

Analysis of CT features and misdiagnosis of renal oncocytoma / 实用放射学杂志

Objective To investigate the CT features of renal oncocytoma(RO),and to analyze the causes of misdiagnosis.Methods CT and clinical data of 1 2 patients with RO confirmed by surgery and pathology were analyzed retrospectively,the CT features and the causes of misdiagnosis before operation were analyzed and summarized.Results According to CT features before operation,among the 1 2 cases of RO,9 were misdiagnosed as renal carcinoma,3 were considered as benign occupying lesions.There were 6 cases located in the left kidney and 6 in the right kidney.Seven cases showed round mass and 5 showed irregular mass.Plain CT showed homogeneous masses in 6 cases and heterogeneous masses in 6 cases.Enhanced CT showed masses with homogeneous enhancement in 2 cases and masses with progressive enhancement in 10 cases.The attenuation value of parenchymal enhancement ranged from 41 to 143 HU (mean 90.17 HU).Seven cases had central scar syndrome,of which 1 case had calcification in the scar.One case showed segmental enhancement inversion,8 showed conical interface and 5 had holding ball signs.Conclusion The CT features of RO is central scar syndrome, segmental enhancement inversion,conical interface and holding ball sign,etc,but the definitive diagnosis still rely on pathology.

Association of FokI rs2228570 and TMPRSS6 rs855791 polymorphisms with cow's milk protein allergy in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the association of polymorphisms of FokI rs2228570 in the vitamin D receptor (VDR) gene and TMPRSS6 rs855791 with cow's milk protein allergy (CMPA) in children.</p><p><b>METHODS</b>Quantitative real-time PCR was used to analyze the single nucleotide polymorphisms of FokI rs2228570 in the VDR gene and TMPRSS6 rs855791 in 100 children with CMPA and 100 healthy children (control group). The multivariate logistic regression model was used to identify the risk factors for CMPA.</p><p><b>RESULTS</b>There were significant differences in the frequencies of CC, CT, and TT genotypes of TMPRSS6 rs855791 between the CMPA and control groups (P=0.008), and the CMPA group had a significantly higher frequency of TT genotype. The multivariate logistic regression analysis showed that the children with TT genotype of rs855791 had an increased risk of CMPA (OR=3.473, P=0.011). However, there was no significant difference in the genotype distribution of FokI rs2228570 in the VDR gene between the two groups (P=0.686).</p><p><b>CONCLUSIONS</b>TMPRSS6 rs855791 polymorphism is associated with CMPA in children, and TT genotype may be the susceptible genotype of CMPA. FokI rs2228570 polymorphism is not associated with CMPA.</p>