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Based on the theory of "Johari Window", this study introduced how to stimulate information content obtained in doctor-patient communication and how to apply the comprehensive geriatric assessment creatively from the four modules of open area, blind area, hidden area and unknown area in the model. It helped students to gain the trust and cooperation of patients, rapidly narrow down the blind area, hidden area and unknown area, guide patients to actively extend the open area, improve the teaching quality of doctor-patient communication in a scientific way.
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The concept of a community of common health for mankind profoundly expresses China’s important proposition of promoting the health and well-being of people in various countries and jointly maintaining global public health security, which has a distinct formation logic. The idea of a community of common health for mankind is rooted in the "real community" theory of Marxist, reflecting its value orientation in the field of global health, and highlighting the new era’s inherent requirements of "adhering to the people first". It is an organic unity of theoretical logic, value logic, and practical logic. The construction of a community of common health for mankind gathers broad consensus, highlights the distinct theme of world peace and development, responds to international concerns, and provides Chinese proposals and contributes Chinese strength for governing global public health, practicing multilateralism, and promoting the construction of new international relations.
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Objective:To investigate the consistency and diagnostic efficiency of Chinese Thyroid Imaging Reporting and Date System (C-TIRADS) in thyroid nodule evaluation by different seniority sonographers.Methods:The preoperative ultrasonographic datum of 134 thyroid nodules in 112 patients from January to November 2020 were independently analyzed by sonographers with different seniority. According to the C-TIRADS guidelines, the C-TIRADS ultrasonographic indicators of each nodule were recorded and C-TIRADS classification was performed. Cohen′s Kappa (K) statistical method was used to analyze the consistency of ultrasonic indicators evaluated by different seniority sonographers. Using postoperative pathological results as the gold standard, the diagnostic efficacy of C-TIRADS classification for differentiating benign and malignant thyroid nodules by junior and senior sonographers was calculated respectively, and the Receiver Operating Characteristic (ROC) curves were drawn respectively.Results:The solid structure and vertical orientation of thyroid nodule judged by different seniority sonographers were very consistent ( K=0.84, 0.81). The consistencies of very hypoechoic and microcalcifications were substantial agreement ( K=0.80, 0.61), and moderate ( K=0.531) for the margin of the nodules. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of distinguishing benign and malignant thyroid nodules by junior and senior sonographers were 91.8%, 65.8%, 77.6%, 69.1%, 90.6% and 96.7%, 67.1%, 80.6%, 71.1%, 96.1%, respectively. The corresponding area under the ROC curves were 0.788 and 0.819, respectively ( Z=1.369, P=0.171). Conclusion:Ultrasonologists with different experience have good consistency in evaluating the C-TIRADS ultrasonic indicators of thyroid nodule, and the diagnostic efficacy of C-TIRADS classification in differentiating benign and malignant thyroid nodule was similar.
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Objective:To evaluate the efficacy of Tongmai-Huaban Decoction combined with conventional western medicine in the treatment of patients with coronary heart disease, and to explore the effects on unstable plaque formation and oxidative stress response. Methods:A total of 120 patients with coronary heart disease in Jiangsu Traditional Chinese Medicine Hospital from March 2020 to March 2021 were randomly divided into two groups by random number table method, with 60 in each group.The control group was treated with aspirin and atorvastatin, and the treatment group was treated with Tongmai-huaban Decoction on the basis of the control group. Both groups were treated for 3 months. The Carotid plaque area and carotid intima-media thickness (cIMT) were measured by color Doppler, the serum MDA and SOD were detected by electrochemiluminescence, the lipid peroxidation (LPO) was detected by double antibody sandwich method, the TNF-α and IL-6 levels were measured by ELISA, and the level of CRP was measured by immunoturbidimetry. The adverse reactions of the two groups were observed, and the clinical efficacy was evaluated. Results:The total effective rate was 91.7% (55/60) in the treatment group and 76.7% (46/60) in the control group, and the difference between the two groups was statistically significant ( χ2=5.016, P=0.024). After treatment, the carotid plaque area [(0.51 ± 0.13) cm 2vs. (0.65 ± 0.16) cm 2, t=5.416] and cIMT [(1.89 ± 0.41) mm vs. (2.11 ± 0.52) mm, t=2.650] in the treatment group were significantly less than those in the control group ( P<0.05); LPO [(3.31 ± 0.83) μmol/L vs. (4.18 ± 1.04) μmol/L, t=5.215], MDA [(2.94 ± 0.77) μmol/L vs. (3.79 ± 0.95) μmol/L, t=5.543] levels were significantly lower than those in the control group ( P<0.05); the level of SOD [(86.56 ± 22.73) U/L vs. (78.79 ± 19.07) U/L, t=2.085] was significantly higher than that of the control group ( P<0.05); the levels of TNF-α, CRP and IL-6 in the treatment group were significantly lower than those in the control group ( t values were 2.557, 6.781 and 6.014, respectively, P<0.05 or P<0.01). The incidence of adverse reactions was 8.3% (5/60) in the treatment group and 10.0% (6/60) in the control group, where there was no significant difference between the two groups ( χ2=0.100, P=0.751). Conclusion:Tongmai-Huaban Decoction combined with conventional western medicine can improve the clinical symptoms of patients with coronary heart disease and reduce plaque instability, inflammatory cytokine level and oxidative stress response.
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OBJECTIVE：To provide reference for r ational use of TCM decoction piece. METHODS ：Electronic questionnaire survey was conducted on the use （dose，ingredient number ）of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces（regions，cities）. Through the hospital information system ，416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM （our hospital ）during May 2016 to Apr. 2019，and were analyzed in terms of prescription dose ，the number of ingredients and use of TCM decoction pieces. At the same time ，the use of TCM decoction piece prescription were analyzed in different departments ，and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS ：The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g，and the average number of ingredients were 11.90-18.25；the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g；55.75％ of the prescription dose were distributed in 201-300 g，and 15.22％ were over 300 g. The average number of ingredients in prescriptions was about 15，and the prescriptions with 11-20 ingredients accounted for 87.75％，those with more than 20 ingredients accounted for 6.64％. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar （85.51％），Atractylodes macrocephala stir-fried with bran （82.10％）and A. macrocephala（79.13％）. The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84％ in our hospital ；there were a lot of TCM prescriptions with dose exceeding 300 g（11.98％ and 18.69％）and the number of ingredients exceeding 18（14.60％ and 9.53％）in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09％. CONCLUSIONS ：The overall dosage of TCM decoction piece prescriptions is relatively high ，the number of ingredients is too much ，and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ，so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.
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@#To improve the standard of quality control of tazobactam and its preparations in China, national reference standard of tazobactam impurity A was developed. After tazobactam impurity A was synthesized, its structure was validated by infrared (IR), mass spectrometry (MS) and nuclear magnetic resonance (NMR), and its content uniformity and short-term stability were measured and investigated. Then, water content and residue on ignition of impurity A were determined, and its purity was determined using high performance liquid chromatography (HPLC) with 10 mmol/L ammonium acetate solution-acetonitrile (98∶2) as the mobile phase. Mass balance method was used to determine the content of the first batch of tazobactam impurity A national standard substance. Meanwhile, nuclear magnetic quantitative method was used to calculate the content, which was mutually verified with the mass balance method. The developed reference material of tazobactam impurity A is consistent with the maximum degradation impurity in tazobactam system applicability solution and the reference material of tazobactam related substance A contained in USP41. Within the 95% confidence range, the ratio of inter- and intra-bottle variance of impurity A after separation was 0.61 (< F0.05(11,12)), proving that the uniformity was satisfying. The contents of organic impurity, water content and inorganic impurity in impurity A were 0.90%, 1.24% and 0.25%, respectively. The content of impurity A was determined to be 97.6% by mass balance method, which was basically consistent with the result of nuclear magnetic quantitative method (97.1%). Under the condition of 25 °C, the area normalized purity of impurity A was 99.1% at 0, 3, 5 and 10 days, proving that the sample was stable at room temperature for 10 days. Finally the first batch of national standard substance of tazobactam impurity A was established successfully.
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Objective To evaluate the effect of high load application of atorvastatin on the clinical outcome of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods Eighty patients diagnosed with AMI were continuously enrolled in this study and randomly divided into two groups:high dose group(n=40) and control group(n=40).Application of high load atorvastatin before operation in loading group.The levels of serum lipid and cardiac function were measured and analyzed.Results The levels of BNP((204±60.3) pg/mL vs.(328.3±67.5) pg/mL;t=1.938,P=0.0315) on 7 days after PCI and levels of LVEF((50.3±6.0)％ vs.(56.9±7.3)％;t=2.169,P=0.019) on 1 month after PCI in high dose group were significantly better than those in control group.Correlation analysis showed that the administration of statin was negatively associated with levels of BNP(r=-0.157,P=0.021) on 7 days after PCI and positively associated with LVEF(r=-0.328,P=0.026) on 1 month after PCI.Conclusion The treatment of high dose statin before PCI may reduce the ischemia-reperfusion injury and prevent the no-reflow development,which therefore improve the cardiac function of AMI patients.
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Objective To explore the significance of serum squamous cell carcinoma antigen (SCC-Ag) in the diagnose of recurrent squamous cell carcinoma of cervix, and seek an effective approach to monitor tumor recurrence after treatment as early as possible. Methods All the data were collected from 1 557 patients with cervical squamous cell carcinoma treated in the First Affiliated Hospital of Bengbu Medical College from Jan. 2004 to Dec. 2010, the data of un-controlled cases(patients whose serum level of SCC-Ag failed to decrease to normal level or patients with incomplete tumor extinction)were eliminated, there were 1 394 cases of complete remission were analyzed,the median age was 46 years( rang, 18-72 years). According to International Federation of Gynecology and Obstetrics stages (FIGO, 1994), 71 cases were in stageⅠa, 360 cases stageⅠb, 254 cases stageⅡa, 207 cases stageⅡb, 95 cases stageⅢa, 289 cases stageⅢb, 106 cases stageⅣa and 12 cases stageⅣb. Radical hysterectomy was performed in 685 cases with stageⅠ-Ⅱa, concurrent radiation and chemotherapy was performed in 709 cases with stageⅡb-Ⅳ. Taking serum cut off value of SCC-Ag was 1.95 μg/L, the level ≤1.95 μg/L as SCC-Ag negative expression and>1.95μg/L as SCC-Ag positive expression. The positive expression status of SCC-Ag before treatment, the relationship between the post-treatment recurrence rate after SCC-Ag becoming negative and the clinicopathological features of the patients with cervical squamous cell carcinoma were analyzed, concurrently combined with gynecological check-up, pathological and imaging examination, followed by comparative analysis with the results of monitoring. Results Among 1 394 patients with cervical squamous cell carcinoma, there were 1 169 cases with positive SCC-Ag, the positive expression rate of SCC-Ag before treatment was closely related with the clinical stages and tumor size(all P0.05). The positive expression of SCC-Ag in 1 169 patients before treatment turned negative after treatment, 279 patients with recurrence whose positive expression of SCC-Ag turned negative after treatment, the recurrence rate was closely related with clinical stages, pathological grade, lymphatic metastasis and tumor size(all P5μg/L for patients with central recurrence was 4.2%(4/96), whilein the group of pelvic wall recurrence group was 56.2%(45/80)and in distant metastasis group was 87.4%(90/103). The level of SCC-Ag>5μg/L from the patients with pelvic wall recurrence and distant metastasis were much higher than that of patients with central recurrence (P<0.01), and the same results were shown between distant metastasis group and pelvic wall recurret group (P<0.01). Conclusions SSC-Ag expression in serum of patients with cervical squamous carcinoma is closely related with clinical stages and the tumor size. Dynamic monitoring the level of SSC-Ag could contribute to the early diagnosis for tumor recurrence, but it has some limitations for patients with central recurrence, which should deserve our attention.
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Objective To investigate the effects of Mahuang-Xixin-Fuzi decoction on the plasma levels of interlcukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in allergic rhinitis in rats. Methods Thirty-two Wistar rats were randomly divided into a control group, a model group, a chlorpheniramine group, and a Mahuang-Xixin-Fuzi decoction group, with 8 rats in each group. Allergic rhinitis was induced by ovalbumin sensitization. Rats in the chlorpheniramine and Mahuang-Xixin-Fuzi decoction groups received intragastric administration of 0.01%chlorpheniramine and Mahuang-Xixin-Fuzi decoction 0.4 g (twice daily for 21 days), respectively. The plasma levels of IL-6 and TNF-αwere measured with enzyme-linked immunosorbent assay. Results The frequencies of sneezing (2.4 ± 0.9/30 min vs.18.5 ± 3.6/30 min) and nasal rubbing (4.2 ± 1.5/30 min vs. 31.2 ± 3.7/30 min) in the Mahuang-Xixin-Fuzi decoction group were significantly lower than those in the model group (all P<0.05). The plasma levels of IL-6 (153.00 ± 13.87 pg/ml vs. 230.38 ± 33.92 pg/ml) and TNF-α(21.25 ± 4.62 pg/ml vs. 56.38 ± 7.93 pg/ml) in the Mahuang-Xixin-Fuzi decoction group were significantly lower than those in the model group (all P<0.05). Conclusions Mahuang-Xixin-Fuzi decoction can reduce the plasma levels of IL-6 and TNF-α, and alleviate symptoms in allergic rhinitis in rats.
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This paper systematically summarizes treatment contraindicationsof the prescription Guizhi decotion, Mahuang decotion, Guizhi 2 yuebi 1 decotion, Daqinglongdecotion, Lingguizhugandecotion, Zhizichi decotion, Baihu decotion, Chengqi decoction, Zhuling decotion , Xiaochaihu decotion, Taohechengqi decotion, Guizhi adding Shaoyao decotion, Guizhi adding dahuang decotion, Sinidecotion, Huangqin decotion in Treatise on Febrile Disease. Doctors should pay attention to thesetreatment contraindications forbetter syndrome differentiational treatment, thus to improve its clinical efficacy.
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<p><b>UNLABELLED</b>To determine the contents of aflatoxin B1, B2, G1 and G2 in Nelumbinis Semen using on-line post-column photochemical derivatization-HPLC-FLD method and verify the method by LC-MS method.</p><p><b>METHOD</b>The samples were extracted with MeOH-H2O (80: 20) and purified with inmunoaffinity column, aflatoxins were analyzed by HPLC-FLD with post-column photochemical derivatizaton. The positive samples were further confirmed by LC-MS/MS.</p><p><b>RESULT</b>On optimum conditions, aflatoxin B1, G1 ranging 0.3-30 mg x L(-1) showed a good linear relationship with aflatoxin B2, G2 ranging 0.09-9.0 mg x L(-1) with r >0.999 9. The recoveries ranged between 86.7% and 99.1%, with RSDs all bellow 4.87%. LOD of aflatoxin B1, B2, G1 and G2 were 0.08, 0.03, 0.10, 0.03 microg x kg(-1), respectively. Among 20 Nelumbinis Semen samples, 14 were found to contain aflatoxin B1 ranging from 0.40 to 586 microg x kg(-1). The total content of aflatoxin B1, B2, G1 and G2 were between 0.40 and 602.5 microg x kg(-1). By LC-MS/MS method, the same fragment ions were founded in samples and the control group at the same retention times, ruling out the possibility of false positive samples.</p><p><b>CONCLUSION</b>The method is simple, highly sensitive and reproducible for the determination of aflatoxins in Nelumbinis Semen.</p>
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Aflatoxins , Chemistry , Chromatography, High Pressure Liquid , Chromatography, Liquid , Drugs, Chinese Herbal , Chemistry , Food Contamination , Reproducibility of Results , Sensitivity and Specificity , Tandem Mass SpectrometryABSTRACT
0.05).Except that the wet weight of the epididymis in high-dose group of apigenin was significantly different compared with middle-dose group of apigenin(P 0.05).Cell cycle analysis showed that compared with the negative control group,the percent of diploid cells in low and high-dose group was decreased,the proportion of G0/G1 phase cells in low-dose group of apigenin was reduced(P