Herbal Textual Research on Stephaniae Tetrandrae Radix in Famous Classical Formulas / 中国实验方剂学杂志

By reviewing ancient materia medica， medical and prescription books， combined with modern literature， the textual research of Stephaniae Tetrandrae Radix has been conducted to verify the name， origin， producing area， harvesting and processing methods. Through textual research， the results show that the mainstream name of this herb recorded in the past dynasties is Fangji， which is also called Hanzhong Fangji because it is produced in Hanzhong city， and after the Tang dynasty， it was gradually divided into Hanfangji and Mufangji， and there is the saying that Han Zhushuiqi， Mu Zhufengqi. The names of Fenfangji and Guangfangji were first seen in the republic of China. In addition， Fenfangji was once distributed in Hankou， so it was also known as "Hanfangji"， which is easily confused with the traditional Hanzhong Fangji for short. Based on the original research， it is concluded that Aristolochia heterophylla（Hanzhong Fangji）is the mainstream of Stephaniae Tetrandrae Radix used in the Qing dynasty and before， and the application history of Cocculus orbiculatus can be traced back to before the Tang dynasty. After the Ming dynasty， Stephania tetrandra gradually became another main origin， and in the Republic of China， A. fangchi was used as a medicine for Stephaniae Tetrandrae Radix， but in modern times it was banned because it contained aristolochic acid as a toxic ingredient， and S. tetrandra has become the mainstream legal origin. The traditional production area of Hanzhong Fangji is Hanzhong， Shaanxi province， while today the mainstream of S. tetrandra is manly produced in Jiangxi and other places. Based on the quality evaluation research， the quality of Hanzhong Fangji is better with the radial texture of section used as radial solution， yellow solid and fragrant. Fenfangji with solid quality， white inside， powdered enough， less fiber and radiating texture is better. From the harvesting and processing research， the root of Fangji is mostly harvested in spring and autumn， and the outer bark should be removed in some literature. Before the Ming dynasty， this herb was dried in the shade， and after the Ming dynasty， it was dried in the sun. The modern production processing of Fangji is to harvest it in autumn， wash it， remove the rough bark， dry it to half dry， cut it into sections， and then cut it longitudinally if it is large， and dry it. Based on the results， combined with current studies on the toxicity of aristolochic acid and influencing factors such as commercial circulation， it is suggested that S. tetrandra should be used as the origin of Fangji， the processed products are selected according to the prescription requirements， and those without specified requirements can be processed by referring to the raw products in the 2020 edition of Chinese Pharmacopoeia.

Local muscle load and fatigue of simulated high-voltage cable climbing task of operation inspection personnel by surface electromyography / 环境与职业医学

Background Climbing pylons during high-voltage cable maintenance is not only a labor-intensive task, but also a challenge bringing about heat stress and mental pressure from working at height, which may lead to accumulation of muscle fatigue and work-related musculoskeletal disorders. Objective To record the local muscle fatigue during a simulated climbing task by high-voltage cable electricians based on surface electromyography (sEMG) signals, explore the characteristic changes in sEMG signals and their relationship with subjective fatigue evaluation of the task, and provide data support for developing task specific objective assessment tools for local muscle fatigue and prevention of work-related musculoskeletal disorders. Methods Ten male college students were recruited to conduct a test of a simulated pylon climbing task. The climbing distance was 60 m, and a task segment was set for every 20 m (about 100 s), recorded as T1, T2, and T3, respectively. After completing each task segment, the subjects were required to rate their subjective fatigue using the Borg's RPE Scale. Fatigue was defined by rating of perceived exertion (RPE) score ≥ 14 in this study. The sEMG signals of trapezius, erector spinae, rectus femoris, and gastrocnemius muscles were recorded wirelessly. The standardized maximal voluntary electrical activation (MVE) obtained by standardizing the root mean square (RMS) of the time domain index and the median frequency (MF) of the frequency domain index were estimated for the recorded sEMG signals, and joint amplitude and spectrum analysis (JASA) was used to evaluate local muscle fatigue of target muscles involving in the climbing task. Results The RPE scores of T1, T2, and T3 were 11.9, 15.3, and 17.4, respectively. Subjective fatigue was found in T2 and T3 but not in T1. With the extension of climbing time, the MVE values of left and right erector spinae muscles, left and right rectus femoris, and right gastrocnemius muscle increased gradually, while the MVE values of left and right trapezius muscles and left gastrocnemius muscle increased first and then decreased. The MF values of left and right rectus femoris increased at first, then remained unchanged, while the MF values of the other muscles remained basically unchanged. In T1, three muscles, including left trapezius muscle and both side of erector spinae muscles, showed fatigue; in T2, five muscles, including both sides of erector spina muscles, right trapezius muscle, and both sides of gastrocnemius muscle appeared fatigue; in T3 , except for left rectus femoris, the other seven muscles were fatigue. Conclusion The characteristic changes of electromyography signals in the simulated climbing task are not completely consistent with the typical amplitude increase and left shift of the frequency spectrum of sEMG signals in static tasks, indicating that the application of time-domain and frequency-domain analysis methods in the evaluation of muscle fatigue in climbing tasks needs further discussion. Trapezius muscles and erector spinae muscles are the first to show fatigue in the simulation, and may be the sensitive muscle groups of muscle fatigue associated with climbing movement. Compared with subjective evaluation, surface electromyography is more sensitive in the assessment of body fatigue. Fatigue is reported about 100 s of climbing (the climbing length is about 20 m).

Effect of long working hours on work-related musculoskeletal disorders among operation and maintenance workers of power supply enterprises / 环境与职业医学

Background Long working hours is harmful to the physical and mental health of occupational groups, and should receive active attention. Objective To evaluate the current status of long working hours among operation and maintenance workers of power supply enterprises, and explore its effects on work-related musculoskeletal disorders (WMSDs) of the population. Methods From March to June 2021, a cross-sectional survey was conducted among 1433 operation and maintenance workers from 10 power supply enterprises in Jilin Province, Shandong Province, and Tianjin Municipality using cluster sampling. A total of 1433 copies of revised Mus-culoskeletal Disorders Questionnaire were distributed, 1343 questionnaires were recovered, and the recovery rate was 93.72%. The questionnaire included general information, personal health behaviors, weekly working hours, work-related factors, and musculoskeletal pain or discomfort in nine body parts in the past 12 months. χ2 test and multiple logistic regression models were used to investigate the relationships between long working hours (>40 h per week) and WMSDs. Results The average age of the workers was (39.42±9.89) years, and the average work experience was 11.00 (5.00, 21.00) years. There were 1158 males (86.22%) and 185 females (13.78%). The average weekly working hours of the workers were (47.98±11.35) h, and the proportion of long working hours (>40 h per week) was 61.06% (820/1343). The proportions of long working hours were higher among the workers with characteristics of male, power distribution, shift work, often/very often long-time standing, often/very often holding awkward postures, often handling heavy objects, limited space to operate, long-time neck tilting backward, keeping arms above shoulders, frequent elbow bending, repeating knee movement every minute, and repeating lower limb or foot movement every minute (all P<0.05). The prevalence rate of WMSDs was 81.53% (1095/1343) among the workers. The results of multiple logistic regression showed that after adjusting education, smoking, exercise, awkward postures, often handling heavy objects, limited space to operate, long-time heavy trunk bending, long-time neck tilting backward, and keeping arms above shoulders, compared with working ≤40 h per week, the risk of WMSDs among workers working >49 h per week was higher (OR=1.406, 95%CI: 1.011-1.955). Conclusion Long working hours is prominent among operation and maintenance workers of power supply enterprises, and increases the risk of reporting WMSDs.

Neck and shoulder pain among operation and maintenance workers of selected power supply enterprises / 环境与职业医学

Background Power grid is a basic industry of national economy. The occupational health problems among operation and maintenance workers in this industry have become increasingly prominent in recent years, and they should receive enough attention. Objective To estimate the prevalence of work-related musculoskeletal disorders (WMSDs) of neck and shoulder among operation and maintenance workers of power supply enterprises, and analyze related influencing factors. Methods From March to June 2021, a total of 1433 operation and maintenance worker from 10 power supply enterprises in three provinces of North China were selected as research subjects using cluster sampling method. A revised Musculoskeletal Disorders Questionnaire was used to investigate the prevalence and ergonomic factors of neck and shoulder pain in the past year. χ2 test and logistic regression model were used to explore influencing factors of neck and shoulder pain among operation and maintenance workers. Results A total of 1343 valid questionnaires were recovered and the effective recovery rate was 93.72%. The neck pain prevalence was 66.0% (886 cases) and the shoulder pain prevalence was 54.1% (727 cases). The multiple logistic regression analysis results showed that often/very often long-time sitting (OR=1.864, 95%CI: 1.236-2.811; OR=1.659, 95%CI: 1.091-2.524), sometimes holding awkward postures (OR=1.695, 95%CI: 1.294-2.219; OR=1.596, 95%CI: 1.218-2.092), often/very often holding awkward postures (OR=2.416, 95%CI: 1.618-3.607; OR=2.058, 95%CI: 1.405-3.015), long-time slight neck tilting forward (OR=1.327, 95%CI: 1.023-1.722; OR=1.571, 95%CI: 1.221-2.022), long-time elbows bending (OR=1.327, 95%CI: 1.023-1.722; OR=1.506, 95%CI: 1.112-2.040) and department or team staff shortages (OR=1.578, 95%CI: 1.153-2.161; OR=1.831, 95%CI: 1.320-2.539) were associated with higher neck and shoulder pain prevalence rates. While exercise (OR=0.630, 95%CI: 0.492-0.809; OR=0.707, 95%CI: 0.557-0.899) was associated with lower neck and shoulder pain prevalence rates. Doing same work every day (OR=1.704, 95%CI: 1.305-2.225) was associated with a higher neck pain prevalence rate. Awkward postures with ineffectual force (OR=1.808, 95%CI: 1.226-2.665) and often keeping arms above shoulders (OR=1.424, 95%CI: 1.017-1.992) were associated with a higher shoulder pain prevalence rate. Conclusion The prevalence rates of neck and shoulder pian are high among operation and maintenance workers of power supply enterprises in selected three provinces of North China, and the main associated factors include individual factors, awkward work postures, and labor organization.

Prevalence of work-related musculoskeletal disorders and its influencing factors among workers involving climbing task in power supply enterprises / 环境与职业医学

Background Operation and maintenance work in the power grid industry often involving climbing, manual handling, and poor postures causing serious problems like work-related musculoskeletal disorders (WMSDs). The influencing factors of WMSDs are not very clear, but the problem has been widely concerned in this industry. Objective To understand the prevalence and influencing factors of WMSDs among climbing task-involved workers in power supply enterprises. Methods Using a cross-sectional design, a total of 702 workers involving climbing task from 10 power supply enterprises in Jilin Province, Tianjin Municipality, and Shandong province were selected as study subjects using cluster sampling. The Musculoskeletal Disorders Questionnaire which was revised by Lei Yang was used to estimate the prevalence and identify related factors of WMSDs. \begin{document}$ {\chi

Phenolic glycosides from the stems and twigs of Strychnos cathayensis and their biological activities / 药学学报

Fourteen compounds were isolated from the n-butanol fraction of the 95% aqueous ethanol extract of the stems and twigs of Strychnos cathayensis by D101 macroporous resin, silica gel, ODS, Sephadex LH-20 column chromatography, and semipreparative RP-HPLC. Their structures were elucidated as ethyl 4-O-β-D-allopyranosyl-vanillate (1), n-butyl 4-O-β-D-allopyranosyl-vanillate (2), n-butyl 4-O-(6′-O-syringoyl)-β-D-allopyranosyl-vanillate (3), n-butyl 4-O-(6′-O-vanilloyl)-β-D-allopyranosyl-vanillate (4), n-butyl 4-O-(6′-O-syringoyl)-β-D-glucopyranosyl-vanillate (5), n-butyl 4-O-α-L-rhamnopyranosyl-syringate (6), methyl 3-methoxy-4-(β-D-allopyranosyloxy) benzoate (7), pseudolaroside B (8), butyl syringate (9), glucosyringic acid (10), methyl syringate (11), methyl 4-hydroxy-3-methoxybenzoate (12), clemochinenoside C (13), and clemoarmanoside A (14), respectively, on the basis of spectroscopic data interpretation and by comparison with literature information. Compounds 1-6 are artificial products of phenolic acid esterified by ethanol or n-butanol. It is noted that the precursors (4-O-(6′-O-syringoyl)-β-D-allopyranosyl-vanillic acid and 4-O-(6′-O-vanilloyl)-β-D-allopyranosyl-vanillic acid) of compounds 3 and 4 are new compounds. The hepatoprotective, anti-inflammatory, antioxidant and cytotoxic activities of compounds 1-13 were evaluated in vitro at a concentration of 10 μmol·L-1. Compounds 1, 2 and 6-10 exhibited potential hepatic protection effects with cell survival rates ranging from 53.6% to 55.5% (acetaminophen, 45.4% at 8 mmol·L-1). Compound 4 demonstrated anti-inflammatory activity with nitric oxide inhibitory rate of 74.6%. Compounds 3 and 5 showed potential antioxidant activities with malondialdehyde inhibitory rates of 53.2% and 56.1%, respectively.

Expression and Detection Value of 6 Chlamydia Trachomatis Protein Antibodies in Tubal Factor Infertility / 中山大学学报(医学科学版)

ObjectiveTo further study the pathogenic role of different types of Chlamydia trachomatis （CT） proteins in tubal factor infertility， evaluate the clinical detection value of Chlamydia trachomatis protein antibody in predicting tubal factor infertility. MethodsA total of 58 cases of tubal factor infertility （TFI）， 41 cases of fertile controls （FC） and 18 cases of infertile controls （IFC） were included. For serum detection， first， CT-IgG ELISA kit was used to detect the expression of CT-IgG in serum of three groups of people； then， 6 kinds of Chlamydia trachomatis proteins were expressed and purified in the early stage to establish the antibody test for these proteins， and ELISA detection method was used to detect the expression of their antibodies in the serum of TFI group， FC group and IFC group， respectively； and finally， the antibody OD value of the 6 kinds of Chlamydia trachomatis proteins in the three groups of subjects were statistically described， and CT-IgG was used as the reference standard to draw the receiver operating characteristic curve （ROC curve） of each CT antibody. The Youden Index determines the cutoff value for each antibody. Taking TFI as the reference class， two disordered multiple classification logistic regression models were established with the FC and IFC groups， respectively； and the reference class was used to explore the value of various antibodies and age in predicting TFI， FC and IFC of Chlamydia trachomatis. The back-off method was used to screen the variables. ResultsThe OD value of CT376 antibody in the TFI group was higher than that in the FC group （0.86 vs. 0.60， P=0.026）. The CT376 antibody OD value in the TFI group was higher than that in the IFC group （0.86 vs. 0.64， P=0.026）. The CT443 antibody OD value in the IFC group was higher than that in the TFI group （0.59 vs. 0.34， P=0.036） and higher than that in the FC group （0.59 vs. 0.30， P=0.02）. The multiple classification logistic regression analysis established between TFI and FC showed that CT-IgG ［P<0.001， OR=0.084， 95%CI （0.025， 0.284）］， CT376 antibody ［P=0.068， OR=0.359， 95%CI （0.120， 1.078）］. CT-IgG is an independent risk factor for tubal infertility， and CT376 antibody cannot be an independent risk factor for tubal infertility. The multiple classification logistic regression analysis established between TFI and IFC showed that among infertile patients， CT-IgG ［P<0.05， OR=0.194， 95%CI （0.046， 0.817）］， CT376 antibody ［P<0.05， OR=0.176， 95%CI （0.038， 0.818）］ and CT381 antibody ［P<0.05， OR=0.112， 95%CI （ 0.016， 0.796）］ were independent risk factors for tubal infertility. ConclusionThe expression of CT376 antibody in tubal infertility patients is higher than that in fertile and infertile controls， suggesting that CT-induced tubal factor infertility may be related to CT376. CT-IgG， and CT376 antibodies are meaningful in predicting CT-induced tubal factor infertility.

Prenatal and postnatal echocardiography evaluation of left atrial appendage aneurysm / 中国医师杂志

Objective:To summarize the ultrasonophic features of left atrial appendage aneurysm, and to provide an important reference for the early and accurate diagnosis of left atrial appendage aneurysm.Methods:Patients with atrial appendage aneurysm have no obvious symptoms in the early stage, and there are many difficulties and challenges in diagnosis. This paper analyzed and summarized the diagnostic characteristics of a child with left atrial appendage aneurysm by combining the prenatal and postnatal ultrasonic imaging characteristics.Results:Echocardiography is the first choice for the diagnosis of left atrial appendage aneurysm. Some cases can make precise diagnosis prenatally.Conclusions:Echocardiography is the preferred imaging examination method for evaluating left atrial appendage aneurysm. Multimodal imaging technology can identify and diagnose left atrial appendage aneurysm early and accurately, and provide important basis for clinical diagnosis and treatment plan.

Countermeasures of "early clinical, multi-clinical and repeated clinical" for medical undergraduates / 中华医学教育探索杂志

In 2012, Chongqing Medical University was approved to be the first batch of pilot universities in China for excellent doctor education and training program, which started the exploration of "early clinical, multi-clinical and repeated clinical" for medical students, and put it into practice in clinical medicine of Batch 2015 ("5+3" integrated specialty). This paper applies the methods of literature research, questionnaire survey and empirical research to understand the needs and suggestions of students for clinical practice. It is suggested that the concept of "early clinical practice" should be integrated into the theoretical teaching, the teaching method of "case introduction" should be adopted in the course of integrated medicine education, the course of Clinical Skills should be reformed, the clinical practice activities such as "early admission to the ward" should be carried out, and the evaluation system of clinical practice should be rebuilt, hoping to provide references for the exploration of "early clinical, multi-clinical and repeated clinical" in medical education of other colleges and universities.

Influencing factors for lymph node metastasis and prognosis in stage T1 and T2 esophageal squa-mous cell carcinoma after radical surgery and construction of nomogram prediction models / 中华消化外科杂志

Objective:To investigate the influencing factors for lymph node metastasis and prognosis in stage T1 and T2 esophageal squamous cell carcinoma after radical surgery and construct nomogram prediction models.Methods:The retrospective cohort study was conducted. The clinico-pathological data of 672 patients with T1 and T2 esophageal squamous cell carcinoma who were admitted to the Affiliated Hospital of North Sichuan Medical College from January 2014 to December 2019 were collected. There were 464 males and 208 females, aged (65±8)years. All patients under-went radical esophagectomy+2 or 3 field lymph node dissection. Observation indicators: (1) lymph node dissection, metastasis and follow-up. (2) risk factors for lymph node metastasis of esophageal cancer after radical resection. (3) prognostic factors of esophageal cancer after radical resection. (4) construction and evaluation of the prediction models of lymph node metastasis and prognosis of esophageal cancer after radical resection. Follow-up was conducted using outpatient examination, telephone and internet consultations to detect survival of patients up to April 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Kaplan-Meier method was used to calculate survival rate and draw survival curve. Log-Rank test was used for survival analysis. Logistic regression model was used for univariate and multivariate analyses of risk for lymph node metastasis, and COX regression model was used for univariate and multivariate analyses of prognosis. Based on the results of multi-variate analysis, the nomogram prediction models for lymph node metastasis and prognosis predic-tion were constructed. The prediction discrimination of the nomogram models were evaluated using the area under curve (AUC) of the receiver operating characteristic curve (ROC). The calibration curve was used to evaluate the prediction consistency of the models. Results:(1) Lymph node dissection, metastasis and follow-up. The number of lymph node dissected was 14±8 and the number of lymph node metastasis was 2(range, 1?19) in 672 patients. Of the 672 patients, there were 182 cases had lymph node metastasis, including 58 cases in T1 stage and 124 cases in T2 stage. All 672 patients were followed up for 38 (range, 1?85)months. The average overall survival time of 672 patients was 65 months, with the 1-, 3-, 5-year overall survival rate as 89.0%, 74.3%, 66.0%, respectively. The average overall survival time of 325 patients in T1 stage and 347 patients in T2 stage were 70 months and 61 months. The 1-, 3-, 5-year overall survival rate of 325 patients in T1 stage and 347 patients in T2 stage were 95.0%, 83.5%, 73.4% and 87.4%, 69.9%, 59.2%, respectively, showing a significant difference in survival between them ( χ2=14.51, P<0.05). (2) Risk factors for lymph node metastasis of esophageal cancer after radical resection. Results of univariate analysis showed that tumor location, tumor histological grade, tumor T staging were related factors affecting lymph node metastasis of esophageal cancer after radical resection ( odds ratio=1.40, 1.54, 2.56, 95% confidence interval as 1.07?1.85, 1.20?1.99, 1.79-3.67, P<0.05). Results of multivariate analysis showed that tumor location, tumor histological grade, tumor T staging were independent factors affecting lymph node metastasis ( odds ratio=1.42, 1.61, 2.63, 95% confidence interval as 1.07?1.89, 1.25?2.09, 1.82?3.78, P<0.05). (3) Prognostic factors of esophageal cancer after radical resection. Results of univariate analysis showed that preoperative comorbidities, postoperative complications, tumor histological grade (G3), tumor T staging, tumor N staging (N1 stage, N2 stage, N3 stage), tumor TNM staging (Ⅲ stage, Ⅳ stage) were related factors affecting prognosis of esophageal cancer after radical resection ( hazard ratio= 1.48, 1.64, 2.23, 1.85, 2.09, 4.48, 4.97, 3.54, 5.53, 95% confidence interval as 1.08?2.03, 1.20?2.23, 1.47?3.39, 1.34?2.54, 1.44?3.04, 2.89?6.95, 1.57?15.73, 2.48?5.05, 1.73?17.68, P<0.05). Results of multivariate analysis showed that preoperative comorbidities, G3 of tumor histological grade, T2 stage of tumor T staging, N1 stage, N2 stage, N3 stage of tumor N staging were independent risk factors affecting prognosis of esophageal cancer after radical resection ( hazard ratio=1.57, 1.89, 1.63, 1.71, 3.72, 3.90, 95% confidence interval as 1.14?2.16, 1.23?2.91, 1.17?2.26, 1.16?2.51, 2.37?5.83, 1.22?12.45, P<0.05). (4) Construction and evaluation of the prediction models of lymph node metastasis and prognosis of esophageal cancer after radical resection. Based on the results of multivariate analysis, tumor location, tumor histological grade, tumor T staging were applied to construct a nomo-gram model for lymph node metastasis prediction of esophageal cancer after radical resection, the score of tumor location, tumor histological grade, tumor T staging were 82, 100, 100, respectively, and the sum of the scores corresponding to the lymph node metastasis rate. Preoperative comor-bidity, tumor histological grade, tumor T staging, tumor N staging were applied to construct a nomo-gram model for 1-, 3-, 5-year overall survival rate prediction of esophageal cancer after radical resection, the score of preoperative comorbidity, tumor histological grade, tumor T staging, tumor N staging were 23, 38, 27, 100, respectively, and the sum of the scores corres-ponding to the 1-, 3-, 5-year overall survival rate. Results of ROC showed that the AUC of nomogram model for lymph node metastasis prediction after radical esophagectomy was 0.66 (95% confidence interval as 0.62?0.71, P<0.05). The AUC of nomogram model for 1-, 3-, 5-year overall survival rate prediction after radical esophagectomy were 0.73, 0.74, 0.71 (95% confidence intervals as 0.66?0.80, 0.68?0.79, 0.65?0.78, P<0.05). Results of calibration curve showed that the predicted lymph node metastasis rate and the predicted 1-, 3-, 5-year overall survival rate by nomogram models were consistent with the actual lymph node metastasis rate and 1-, 3-, 5-year overall survival rate. Conclusions:Tumor location, tumor histological grade, tumor T staging are independent factors affecting lymph node metastasis in T1 and T2 esophageal squamous cell carcinoma after radical surgery and nomogram model constructed by these indicators can predict the lymph node metas-tasis rate. Preoperative comor-bidities, G3 of tumor histological grade, T2 stage of tumor T staging, N1 stage, N2 stage, N3 stage of tumor N staging are independent risk factors affecting prognosis and nomogram model constructed by these indicators can predict the overall survival rate of patients after surgery.

Study on factors in patients to get rid of blindness with post traumatic infectious endophthalmitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the factors affecting patients with post traumatic infectious endophthalmitis(PTIE)relieving from blindness.METHODS: A retrospective study was conducted on 169 patients(169 eyes)with PTIE from January 2010 to December 2020 in the department of ophthalmology, the Affiliated Hospital of Nantong University. After treatment of intravitreal injection of antibiotics(IVIA)and/or pars plana vitrectomy(PPV), the patients were divided into the getting rid of blindness group(103 eyes)and unilateral blindness group(66 eyes)according to the last follow-up of best correct visual acuity(BCVA)≥0.05. The factors affecting the patients to get rid of blindness were analyzed.RESULTS: The rate of relieving from blindness was 53.5%. Univariate analysis showed that BCVA before treatment ≥ hand movement, no retinal detachment, fundus grade of endophthalmitis < grade 3 and no strong virulence of infected microorganisms were beneficial for patients to get rid of blindness(P<0.05). Multivariate Logistic regression analysis identified that BCVA before treatment ≥ hand movement(OR=0.253, 95%CI: 0.108-0.592)and no retinal detachment(OR=0.241, 95%CI: 0.103-0.564)were favorable factors for patient to get rid of blindness.CONCLUSION: Better BCVA before treatment, no retinal detachment, endophthalmitis fundus grade < 3, and no strong virulence of infected microorganisms are favorable factors for patients with PTIE to get rid of blindness finally.

Herbal Textual Research on Armeniacae Semen Amarum in Famous Classical Formulas / 中国实验方剂学杂志

By consulting ancient Chinese herbal medicines and medical books， the textual research of Armeniacae Semen Amarum has been conducted to verify the name， origin， producing area， quality evaluation， harvesting and processing changes. Through textual research， Shennong Bencaojing began to contain Xinghe. After Xinxiu Bencao， Xingheren were gradually taken as the mainstream name， Xingren was first used as the correct name since Leigong Paozhilun， and gradually became the mainstream rectifying in the Ming and Qing dynasties. Before the Qing dynasty， there was no distinction between Armeniacae Semen Amarum and Armeniacae Semen Dulcis in the materia medica works， while the differences between them were clearly defined in some works of the Qing dynasty， but did not record them separately. In order to make them more accurate in clinical application， Armeniacae Semen Amarum was recorded as the correct name in the 1953 edition of Chinese Pharmacopoeia， and Armeniacae Semen Dulcis was included in the provincial standards. The original plants of Armeniacae Semen Amarum from Prunus armeniaca （Armeniaca vulgaris in Flora of China） and its cultivated varieties with bitter seeds were taken as the mainstream， which are reflected in the Chinese Pharmacopoeia. Its yellow ripe fruit was generally harvested in May， the seed kernel was taken out for drying or baking， finally the seed coat was removed to use. It is recorded that the production area of Armeniacae Semen Amarum is Taihang Mountain area of Shanxi province in ancient times. At present， its producing area is mainly concentrated in Shanxi， Shandong， Hebei and other places in north China. Historical literature pointed out that Armeniacae Semen Amarum had small toxicity， and heat treatment could reduce toxicity and increase efficiency， its main processing method was blanching and stir-frying. In addition， it is generally believed that raw products with seed coat can enhance its sweating effect since the Ming and Qing dynasties. Until now， three processed products are stipulated in the Chinese Pharmacopoeia， namely raw products， boiled and fried products. Based on textual research， it is recommended that A. vulgaris should be used as the original plant of Armeniacae Semen Amarum in famous classical formulas， and the use of processed products should follow the processing requirements marked in the formulas.

Herbal Textual Research on Ephedrae Herba in Famous Classical Formulas / 中国实验方剂学杂志

Ephedrae Herba is a commonly used medicine for dispersing wind and cold， which has a long medicinal history. By referring to the herbal literature， medical books and prescription books， this paper intends to carry out herbal textual research on the name， origin， medicinal part， producing area， harvesting and processing methods of Ephedrae Herba in famous classical formulas， in order to provide the basis for the development of relevant famous classical formulas. According to textual research， the main base of ancient Ephedrae Herba was Ephedra sinica. The medicinal part is the herbaceous stems of Ephedrae Herba. Before the Northern and Southern dynasties， the origin of the records was Jindi and Hedong， which is now Shanxi province. In the Northern and Southern dynasties and later generations， the producing area expanded， and now it is mainly distributed in Hebei， Shanxi， Shaanxi， Inner Mongolia， Gansu， Liaoning and other places， among which Inner Mongolia is the main producing area. The harvesting and processing methods in the past dynasties are to harvest the stems in autumn， dry them in the shade or air to 70%-80% dry， and then dry them in the sun. The processing methods in the past dynasties mainly include removing the knots， wine-fried， honey-fried， processing with vinegar and so on， at present， only honey-fried is still in use. Based on the research results， it is suggested that Ephedrae Herba in famous classical formulas should be selected the dry herbaceous stems of E. sinica. If the processing requirements are not indicated， it is suggested to use raw products of Ephedrae Herba.

Herbal Textual Research on Schizonepetae Herba in Famous Classical Formulas / 中国实验方剂学杂志

In this paper， the name， classification， origin and other aspects of Schizonepetae Herba in the famous classical formulas were researched by referring to the related herbal literature， medical books and prescription books in the past dynasties. The results showed that Schizonepetae Herba first appeared in Shennong Bencaojing （《神农本草经》） as Jiasu， while Jingjie first appeared in Wupu Bencao （《吴普本草》）， and the name of Jingjie was mainly used as the rectification of name in later generations. The name of Jiasu is mostly derived from its smell， and the name of Jingjie is mostly derived from its pronunciation. Schizonepeta tenuifolia has been highly praised in the past as a original material， and its genuine producing area is Jiangsu， Hebei and other places， medicinal part is whole herb with spike. In modern times， the quality of Schizonepetae Herba is best described as having thin stems， green spike， and aroma. In clinical application， the raw products of Schizonepetae Herba is mainly used， and the carbonisata is mainly used for hemostasis. Famous classical formulas of Huaihuasan and Danggui Yinzi are all made of Schizonepetae Spica， so it is recommended to use the dried panicle of S. tenuifolia. In Liangxue Dihuangtang， Schizonepetae Herba Carbonisata is used， therefore， it is suggested to adopt the processing method of Schizonepetae Herba Carbonisata in the 2020 edition of Chinese Pharmacopoeia.

Crosstalk between CpG Methylation and Polymorphisms (CpG-SNPs) in the Promotor Region of DIO2 in Kashin-Beck Disease / 中国医学科学杂志(英文版)

Objective This study was designed to determine the methylation profile of four CpGs and the genotypes of two CpG-SNPs located in promoter region of DIO2 in patients with Kashin-Beck disease (KBD). We also analyzed the interaction between the CpGs methylations and CpG-SNPs. Methods Whole blood specimens were collected from 16 KBD patients and 16 healthy subjects. Four CpGs and two CpG-SNPs in the promoter regions of DIO2 were detected using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The CpGs methylation levels were compared between samples from KBD patients and healthy subjects. The methylation levels were also analyzed in KBD patients with different CpG-SNP genotypes. Results The mRNA expression of DIO2 in whole blood of KBD patients was significnatly lower than in healthy controls (P <0.05). The methylation levels of DIO2-1_CpG_3 in KBD patients were significantly higher than those in healthy controls (P <0.05). The methylation levels of four CpGs were not significantly different between KBD patients and healthy controls. The methylation level of DIO2-1_CpG_3 in the promoter region of DIO2 in KBD patients with GA/AA genotype was significantly higher than that of KBD patients with GG genotype (P <0.05). Conclusion The methylation level of DIO2 increases in KBD patients. Similar trends exist in KBD carriers of variant genotypes of CpG-SNPs DIO2 rs955849187.

Hepatectomy combined with radiofrequency ablation on liver cross section for hepatocellular carcinoma with microvascular invasion / 中华普通外科杂志

Objective:To evaluate radiofrequency ablation-assisted liver resection on early recurrence of hepatocellular carcinoma(HCC) with microvascular invasion (MVI).Methods:A total of 82 HCC patients from Jun 2015 to Jun 2020 were divided into assisted group ( n=41) and control group ( n=41) after local hepatectomy.And by pathology,both groups were further substratified into with or without MVI subgroups. Results:There was no statistically significant difference in the baseline data between two groups,nor there was difference in recurrence-free survival rate between the two groups ( χ 2=0.177, P=0.674). However, by subgroup analysis, the recurrence-free survival rate of ablation assisted group was higher than that of the simple local hepatectomy group among MVI positive patients ( χ 2=5.096, P = 0.024).Multivariate analysis showed that only tumor diameter ( HR=1.32, 95% CI: 1.02-1.72, P=0.036) was an independent risk factor for local recurrence at the incisal margin, while mode of operation ( HR=0.15 ,95% CI: 0.04-0.52 ,P=0.003) and MVI ( HR=8.65 ,95% CI: 2.19-34.19 ,P=0.002) were independent risk factors for intrahepatic distant metastasis. Conclusion:Local hepatectomy assisted by intraoperative radiofrequency ablation on hepatic cross section could effectively reduce the postoperative early recurrence rate for hepatocellular carcinoma patients with MVI.

Prevalence and risk factors of diabetic retinopathy in Tibet / 中国基层医药

Objective:To investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients in Tibet.Methods:A total of 239 patients with DR who received treatment in Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from December 2017 to December 2018 were included in this study. They were divided into Han nationality and Zang nationality groups according to ethnicity. The condition of DR was evaluated with nonmydriatic ocular fundus photography according to the staging criteria of the severity of retinopathy.Results:The prevalence of DR in Tibet was 18.0％. The prevalence of DR in Tibetan and Han patients with diabetes was 17.5% and 19.2%, respectively. There was no significant difference in the prevalence of DR between Tibetan and Han patients with diabetes ( χ2 = 0.10, P = 0.754). Logistic regression analysis revealed that the risk factors of developing DR in Tibet included diabetes duration ( OR = 1.14, 95% CI: 1.05-1.24, P < 0.05), insulin therapy ( OR = 2.74, 95% CI: 1.09-6.89, P < 0.05), fasting plasma glucose ( OR = 1.37, 95% CI: 1.07-1.75, P < 0.05) and hypertension ( OR = 1.98, 95% CI: 1.02-3.86, P < 0.05). Diabetes duration and fasting plasma glucose are independent risk factors of DR. However, although elevated glycated hemoglobin levels were high in Tibet, they could not be used to predict the risk for developing DR ( OR = 1.01, 95% CI: 0.82-1.25, P > 0.05). Conclusion:Hyperglycemia is an important risk factor of developing DR in Tibet. However, elevated glycated hemoglobin levels cannot be used to predict the risk of developing DR in Tibet. Findings from this study fill the gap in the research on DR prevalence and ethic difference of DR prevalence, providing scientific evidence for prevention and treatment of DR in high-altitude areas.

Report of 8 cases with pediatric chronic non-bacterial osteomyelitis and literature review / 中华实用儿科临床杂志

Objective:To summarize the clinical features of chronic non-bacterial osteomyelitis (CNO) in children.Methods:Clinical data of 8 CNO patients admitted to the Department of Rheumatology and Immunology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2020 were retrospectively analyzed.The clinical characteristics of 8 children with CNO were summarized and compared with those reported abroad.Results:A total of 8 CNO patients were recruited, involving 3 males and 5 females with the mean age of onset (7.2±3.2)years, and the average diagnosis time 25.9 months, respectively.The common clinical symptoms included bone pain (7 cases, 87.5%), arthritis (4 cases, 50.0%), and fever (3 cases, 37.5%). The main manifestations on X-ray and CT scans were bone destruction and progressive osteosclerosis.Magnetic resonance imaging (MRI) showed bone marrow edema, periostitis, soft tissue swelling, and enhancement.All of them had more than one site of bone involvement.Seven patients(87.5%) had bilateral bone involvement, with the most common site of tibia (22.0%), followed by femur (17.1%) and mandible (9.8%). Bone biopsy was performed in 8 patients, and 4 cases showed osteonecrosis, 4 cases showed bone fibrosis and 2 cases showed osteomyelitis.The etiological examination of the bone was negative.Eight children received non-steroid anti-inflammatory drugs alone or in combination with glucocorticoids, disease-modifying antirheumatic drugs (DMARDs), bisphosphonates or tumor necrosis factor-α(TNF-α) antagonists.After treatment, the patients were followed up for 3 months to 2 years.Eight children improved.Their inflammatory indexes were normal, and had no disability, teratology or multiple organ damage.Conclusions:Pediatric CNO is more common in children of school age, with a long course of disease.The main manifestations are multi-site bone pain and arthritis.Imaging studies indicate multiple bone involvement, which is more common at lower extremities.Non-steroids anti-inflammatory drugs, glucocorticoids, DMARDs, bisphosphonates and TNF-α antagonists are effective to CNO.

Comparison of clinical features of Takayasu′s arteritis in children at different ages / 中华实用儿科临床杂志

Objective:To improve the understanding of Takayasu′s arteritis (TA) and its diagnosis and treatment by analyzing and summarizing the clinical characteristics of TA in children at different ages.Methods:Clinical and follow-up data of 41 children with TA admitted in Children′s Hospital, Capital Institute of Pediatrics between January 2010 and May 2020 were retrospectively analyzed.Based on the cut-off age of 3 years, children with TA were divided into older group and younger group.Clinical characteristics, involvement of the coronary artery, blood pressure control and growth restriction between 2 groups were analyzed.Counting data were expressed as percentage and case, and compared by the Chi- square test. Results:Among the 17 children with TA in younger group, there were 8 males and 9 females.There were 6 males and 18 females in older group.The general type was most common in younger group, with 10 cases (58.8%). In older group, thoracic and abdominal aortic type was the most common, with 13 cases (54.2%). The most common clinical manifestation in younger group was fever, with 13 cases (76.5%). In older group, 19 patients (79.2%) had hypertension.Lower hemoglobin (Hb) was detected in younger group.Leukocyte count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) increased in all patients (100.0%). In older group, leukocyte count increased in 6 cases (25.0%), ESR increased in 13 cases (54.2%), and CRP increased in 11 cases (45.8%). The coronary artery and its branches (anterior descending branch and circumvolute branch) were the mostly affected in younger group, with 16 cases (94.1%). The subclavian artery was the most commonly involved in older group (15 cases, 62.5%). All TA children in younger group were in the active stage.Among them, 8 cases were treated with biological agents alone, 3 cases were treated with glucocorticoid alone, 5 cases were treated with the combination of glucocorticoid and biological agents, and 1 case was treated with glucocorticoid first, and then transferred to biological agents due to the poor effect.In older group, there were 18 active-stage patients (75.0%), and 2 refused treatment.Sixteen active patients and 6 inactive patients were treated with glucocorticoid, involving 19 cases treated with glucocorticoid combined with Cyclophosphamide, and 3 cases treated with glucocorticoid combined with biologics.There were 16 cases of coronary artery involvement in younger group and only 1 case in older group ( P<0.01). In younger group, 9 patients had growth restriction, while none was detected in older group ( P<0.01). The blood pressure of younger group was all controlled, which was not satisfactorily controlled in 16 cases of older age ( P<0.01). The incidence of general type and active stage in younger group was higher than that of older group without significant difference ( P>0.05). Conclusions:The clinical characteristics of TA vary at different ages.TA progresses more rapidly in younger children, which are more prone to the involvement of extensive vessels, the coronary arteries and other vessels, and the effects of drugs on growth and development should be well concerned.Older TA patients can be alleviated into the inactive phase by themselves, which is mainly characterized as the involvement of large vessels and hypertension sequelae.

Clinical efficacy of intra-articular injection with Triamcinolone acetonide in patients with juvenile idiopathic arthritis / 中华实用儿科临床杂志

Objective:To observe the clinical efficacy of intra-articular injection with Triamcinolone acetonide on the treatment of juvenile idiopathic arthritis (JIA).Methods:The clinical data of 26 children diagnosed with JIA undergoing the intra-articular injection of Triamcinolone acetonide for the joints with obvious swelling and pain at the Children′s Hospital Affiliated to Capital Institute of Pediatrics from October 2018 to December 2019 who were retrospectively analyzed.Erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) were tested before and after the application of Triamcinolone acetonide.Detailed clinical manifestations were recorded.The nonparametric Kruskal- Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at diffe-rent treatment times. Results:Among the 26 children, 8 were boys and 18 were girls.After the intra-articular injection of Triamcinolone acetonide, 9 cases (34.62%) achieved complete remission, 15 cases(57.69%) achieved partial remission, and 2 cases (7.69%) were not responsive to the intra-articular injection.The overall therapeutic efficacy was 92.31%.Compared with pre-treatment period, from 4 weeks after treatment, assessment of disease activity by the physicians and parents of the children was significantly improved after 4-week treatment, and the number of active joints, ESR and CRP and the Juvenile Arthritis Disease Activity Score with 27 joints (JADAS 27) gradually decreased, and the differences were statistically significant (all P<0.05). No adverse drug reactions were seen during the treatment and follow-up period. Conclusions:Intra-articular injection of Triamcinolone acetonide is effective in contro-lling joint symptoms of JIA with less adverse events.