Research progress on chemical constituents ，pharmacological effects and clinical application of volatile oil from Magnolia liliflora / 中国药房

The volatile oil of Magnolia liliflora ，as the main active part of the medicinal value ，has rich chemical constituents ， mainly including cineole ，farnesol，α-pinene，β-pinene，terpineol，cadinene，linalool，citronellol，camphor. It has a wide range of pharmacological effects ，mainly anti-inflammatory and anti-allergic effects. Clinically ，it is mainly used to treat acute and chronic rhinitis，allergic rhinitis and sinusitis. This paper summarizes the research reports on the volatile oil of M. liliflora at home and abroad in the past 10 years，compares the chemical constituents of the volatile oil from M. liliflora under different conditions （origin，variety，part and extraction method ），combs its pharmacological effects and clinical application status ，and looks forward to its development prospect ，in order to provide reference for the further development of the medicinal value of the volatile oil from M. liliflora .

A comparative study on the prognosis of sepsis caused by acute severe pancreatitis and pneumonia / 中国医师杂志

Objective:To compare the severity of sepsis caused by severe acute pancreatitis (SAP) and community-acquired pneumonia (CAP), improve the understanding of sepsis caused by different types of inflammatory reaction, and provide basis for clinical evaluation of condition and prognosis.Methods:From November 2018 to October 2020, 42 patients with SAP (SAP induced sepsis group) and 68 patients with CAP (CAP induced sepsis group) were selected from Beijing Shunyi Hospital and Dongzhimen Hospital of Beijing University of Chinese medicine. All patients met the diagnostic criteria of sepsis-3 in 2016. The clinical data were analyzed retrospectively, and the indexes, Acute Physiology and Chronic Health Enquiry (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at different time points between the two groups were compared. The correlation between APACHE Ⅱ score and SOFA score and other indicators was analyzed.Results:(1) The mortality rate of SAP induced sepsis group was significantly lower than that of CAP induced sepsis group (2.38% vs 41.18%, P<0.001). The APACHE Ⅱ score and SOFA score of SAP induced sepsis group on the 1st, 3rd and 7th day of hospitalization were significantly lower than those of CAP induced sepsis group at the same time point (APACHE Ⅱ: 10.55±1.16 vs 18.51±0.69, P<0.001, 8.78±0.79 vs 15.45±1.12, P<0.001, 7.77±0.77 vs 12.98±1.08, P<0.001; SOFA: 3.71±0.53 vs 5.57±0.37, P<0.001, 3.24±0.44 vs 5.21±0.52, P<0.001, 2.87±0.14 vs 5.19±0.55, P<0.001). (2) In SAP-induced sepsis group, APACHE Ⅱ score was correlated with lactic acid(Lac), platelet (PLT), PCO 2, creatinine (Cr), aspartate transaminase (AST) and SOFA score, while SOFA score was correlated with Lac, C-reactive protein (CRP), PLT, PO 2, PCO 2, Cr, AST, alanine aminotransferase (ALT) and APACHE Ⅱ score. In CAP-induced sepsis group, APACHE Ⅱ score was correlated with SOFA score. Conclusions:The combination of APACHE Ⅱ score, SOFA score and different clinical indexes has a good indication for judging the severity and prognosis of sepsis patients with different pathogenesis.

Research advances in autoimmune hepatitis-related hepatocellular carcinoma / 临床肝胆病杂志

Autoimmune hepatitis (AIH)-related hepatocellular carcinoma (HCC) is defined as HCC that develops on the basis of long-term AIH and has a relatively low incidence rate of 0-6%. The risk factors for HCC in AIH patients include old age, male sex, diabetes, alcohol use, AIH recurrence and persistent alanine aminotransferase abnormalities, failure in immunosuppressive therapy and related treatments, and long-term liver cirrhosis. Liver cirrhosis is an important stage for the development of HCC in AIH, and the incidence rate of HCC increases significantly after AIH progresses to liver cirrhosis. At present, there are few reports on the mechanism of HCC in AIH, which may be associated with the changes in specific molecular biological characteristics (including chromosomes, telomeres, and genes) induced by liver cirrhosis, the cell death-inflammation-cancer pathway, and intestinal microecological disorders. It is of great importance to identify the AIH population at a high risk of HCC in a timely manner and enhance intervention, follow-up, and monitoring.

Effect of lathyrol derivatives on non-small cell lung cancer and the possible mechanism / 中南大学学报(医学版)

OBJECTIVES@#Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer, with highmorbidity and mortality rate. Nove drug development for NSCLC is urgently needed.This study aims to investigate the activity of lathyrol derivatives and the mechanism for its inhibitory effect on the growth of NSCLC cells.@*METHODS@#Three lathyrol derivatives were synthesized from lathyrol and their structures were verified by nuclear magnetic resonance. MTT assay was used to detect the effects of the lathyrol derivatives on the proliferation activity of NSCLC cells (A549 and H1299 cells), and the compound with the best activity was selected for subsequent experiments. Colony forming assay, wound-healing assay, and transwell assay were applied to detect in vitro cell proliferation, migration and invasion ability in A549 and H1299 cells, respectively. Quantitative real-time RT-PCR and Western blotting were performed to detect mRNA and protein levels of E-cadherin, N-cadherin, β-catenin, and MMP2 in A549 cells, respectively.@*RESULTS@#Three lathyrol derivatives inhibited the growth of A549 and H1299 cells in a dose-dependent manner, and they showed a weak inhibitory effect on normal cells Beas-2B and 16HBE, indicating that they possessed certain selective toxic effects. Therefore, C-5 benzoylated lathyrol with the best activity was selected as the ideal drug for the subsequent experiments. Compared with the control group, the number and size of cell clusters in the treatment group of A549 and H1299 cells were significantly decreased, the relative mobility were significantly decreased, and the number of invaded cells were significantly decreased (all P<0.05), indicating that the in vitro cell proliferation, migration and invasion ability were decreased. The mRNA levels of integrin α2, integrin β1, MMP2, MMP9, β-catenin, and N-cadherin were decreased, while the expression of E-cadherin was increased (all P<0.05). The protein levels of N-cadherin, β-catenin, MMP2, and integrin αV were decreased, while the expression of E-cadherin was increased (all P<0.05).@*CONCLUSIONS@#The lathyrol derivatives synthesized in this study possess good inhibitory activity against NSCLC. Among them, C-5 benzoylated lathyrol significantly inhibits the proliferation, migration, and invasion ability of NSCLC cells in vitro through regulating the process of epithelial-mesenchymal transition.

Analysis of influencing factors of death of epidemic Japanese encephalitis cases in Longnan City, Gansu Province from 2014 to 2018 / 中华地方病学杂志

Objective:To understand the influencing factors of death of epidemic Japanese encephalitis (EJE) cases in Longnan City of Gansu Province.Methods:In the EJE Monitoring Information Report Management System of the Chinese Disease Prevention and Control Information System, data on EJE cases with onset from 2014 to 2018 and current address in Longnan City were derived. An "Individual Questionnaire of Epidemic Japanese Encephalitis in Longnan City" was designed, retrospective study was conducted on enrolled cases, their information on demographic data, consultation, onset, clinical classification, and chronic underlying diseases were collected, characteristics of EJE cases and death-related factors were analyzed.Results:From 2014 to 2018, a total of 260 EJE cases were reported in Longnan City, and 259 cases completed the questionnaire. Among them, 70 cases (27.0%) were aged ≥60 years old, 67 cases (25.9%) were severe and extremely severe, and 55 cases (21.2%) had chronic underlying diseases. Among 259 EJE cases, 46 cases died, with a fatality rate of 17.8%. After multivariate unconditional logistic regression analysis, age ≥60 years old [odds ratio ( OR)=2.667, 95% confidence interval ( CI): 1.140-6.237], severe and extremely severe ( OR = 2.762, 61.820, 95% CI: 1.053-7.091, 5.149-742.239), and chronic underlying diseases ( OR = 2.489, 95% CI: 1.038-5.964) were risk factors for death in EJE cases. Conclusions:The influencing factors of death of EJE cases in Longnan City are age, clinical classification and chronic underlying diseases. Therefore, we should focus on patients over 60 years old, clinically classified as severe or extremely severe, and suffering from chronic underlying diseases, and strengthen the immunization of EJE vaccine for key populations.

Application of online-offline mixed teaching mode in the teaching of histology and embryology / 中华医学教育探索杂志

Objective:To explore the application effect of online-offline mixed teaching mode in the teaching of histology and embryology.Methods:Two classes of students majoring in psychiatry from Batch 2020 were randomized into experimental group ( n = 100), and two classes of students majoring in general practice in 2020 grade were randomized into the control group ( n = 99). The online-offline mixed teaching mode was used in the experimental group, while a traditional teaching mode was used in the control group. The online test scores, final scores and questionnaire satisfaction of the two groups of students were evaluated on the teaching effect. All data were statistically processed by SPSS 19.0, and the comparison between groups was performed by t test. Results:The online test scores of the experimental group [(8.55±1.18) vs. (6.33±0.91)] and final scores [(85.56±3.32) vs. (72.24±2.71)] were significantly higher than those of the control group ( P < 0.05). Compared with the control group, the experimental group's satisfaction scores of the online-offline mixed teaching mode were significantly higher in students' learning interest, learning autonomy, time management ability, teamwork, interactive communication, knowledge understanding and memory ability ( P < 0.05). Conclusion:The online-offline mixed teaching mode can improve the histology and embryology teaching effect and promote the students' interest in learning and autonomous learning ability.

Analysis of iodine nutritional status in patients with thyroid disease / 中华地方病学杂志

Objective:To investigate the relationship between iodine nutrition level and thyroid disease.Methods:Totally 299 patients with thyroid disease who were treated at Shandong Provincial Institute for Endemic Disease Prevention and Control from 2016 to 2018 were selected as case group which was further divided into Graves' disease group (GD group, 137 patients), chronic lymphocytic thyroiditis group (HT group, 90 patients) and thyroid nodule group (72 patients). At the same time, 75 healthy people with no history of thyroid disease, normal thyroid color ultrasound and thyroid function were selected as control group. Morning urine was collected and urinary iodine was detected by arsenic cerium catalytic spectrophotometry. Fasting venous blood was extracted, and serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were detected by electrochemiluminescence method. Results:The difference of median urinary iodine in the 4 groups was statistically significant ( H = 42.530, P < 0.05). The medians urinary iodine in GD and HT groups (326.79, 341.91 μg/L) were higher than those of thyroid nodule group and control group (235.01, 187.32 μg/L, P < 0.05). The levels of TSH, FT 3 and FT 4 in GD group were compared with those of control group, and the differences were statistically significant ( P < 0.05). The positive rates of TgAb and TPOAb in HT group were significantly higher than those in GD, thyroid nodule and control groups, and the positive rates of TgAb and TPOAb in GD group were higher than those in thyroid nodule and control groups ( P < 0.05). Conclusions:GD and HT patients have excessive iodine nutrition, and high iodine intake may lead to the occurrence of these thyroid diseases (GD and HT). Thyroid function test combined with laboratory urinary iodine test can be used to diagnose thyroid diseases simply and quickly.

Genetic analysis of thalassemia among Tujia and Miao people of reproductive age in Chongqing / 中华地方病学杂志

Objective:The aim of this study was to investigate the carrier ratio and the genotype of thalassemia among Tujia and Miao people of reproductive age in Chongqing.Methods:According to forward-looking design and multi-stage stratified cluster sampling method, fasting venous blood samples of Tujia and Miao people of reproductive age were collected from 11 survey sites in Chongqing from March to July 2019. Gap-PCR and high-throughput sequencing were used to screen thalassemia genes.Results:A total of 516 Tujia people (258 males, 258 females) and 270 Miao people (139 males, 131 females) were included in this study, and their age were (28.63 ± 5.26) and (28.62 ± 5.35) years, respectively. About 5.04% (26/516) Tujia people carried thalassemia gene, with 1.94% (10/516) and 2.52% (13/516) for α and β thalassemia, respectively. Three kinds of new variants (1 case of each variant), HBA 2: c.46G>A (Gly>Ser), HBB: c.*+129T>A and HBB: c.-39T>G with unclear pathogenicity, were identified in Tujia people. About 7.78% (21/270) Miao people carried thalassemia gene, among these, α and β thalassemia were 3.33% (9/270) and 4.44%(12/270), respectively. The most common mutation type of α-globin gene was -α 3.7/in the two ethnic groups. Three kinds of β-globin gene mutation types, Codons 41/42 (-TTCT) beta 0, Codon 17 (A>T) beta 0 and IVS-Ⅱ-654 (C>T) beta +, were the most common in Tujia people. Meanwhile, the chief β-globin gene mutation type was Codons 41/42 (-TTCT) beta 0 in Miao people. Conclusions:The carrying rate of thalassemia gene is higher in Tujia and Miao people in Chongqing, and the genotypes of thalassemia gene are different between Tujia and Miao people. The clinical significance of three kinds of new variants with unclear pathogenicity should be focused on.

Repurposing antimycotic ciclopirox olamine as a promising anti-ischemic stroke agent

Ischemic stroke is a severe disorder resulting from acute cerebral thrombosis. Here we demonstrated that post-ischemic treatment with ciclopirox olamine (CPX), a potent antifungal clinical drug, alleviated brain infarction, neurological deficits and brain edema in a classic rat model of ischemic stroke. Single dose post-ischemic administration of CPX provided a long-lasting neuroprotective effect, which can be further enhanced by multiple doses administration of CPX. CPX also effectively reversed ischemia-induced neuronal loss, glial activation as well as blood-brain barrier (BBB) damage. Employing quantitative phosphoproteomic analysis, 130 phosphosites in 122 proteins were identified to be significantly regulated by CPX treatment in oxygen glucose deprivation (OGD)-exposed SH-SY5Y cells, which revealed that phosphokinases and cell cycle-related phosphoproteins were largely influenced. Subsequently, we demonstrated that CPX markedly enhanced the AKT (protein kinase B, PKB/AKT) and GSK3 (glycogen synthase kinase 3) phosphorylation in OGD-exposed SH-SY5Y cells, and regulated the cell cycle progression and nitric oxide (NO) release in lipopolysaccharide (LPS)-induced BV-2 cells, which may contribute to its ameliorative effects against ischemia-associated neuronal death and microglial inflammation. Our study suggests that CPX could be a promising compound to reduce multiple ischemic injuries; however, further studies will be needed to clarify the molecular mechanisms involved.

Clinical and genetic analysis of a patient with slow-channel congenital myasthenic syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a female patient featuring unstable head upright and hypotonia of limbs.@*METHODS@#The child was examined clinically. Peripheral blood samples of the child, her parents and siblings were collected. Genomic DNA was extracted and subjected to next generation sequencing (NGS). Suspected variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#DNA sequencing found that the patient has carried a de novo heterozygous c.354C>A (p.N118K) variant of the CHRND gene, which was not found in her parents and sibling. Bioinformatics analysis predicted that the variant was likely to be pathogenic. Literature review suggested that the phenotype of the patient was very similar to previously reported ones.@*CONCLUSION@#The child was diagnosed with slow-channel congenital myasthenic syndrome (SCCMS) type 3A caused by heterozygous variant of the CHRND gene. NGS has provided a powerful tool for the diagnosis of such disorders.

Observation on the effect of traditional Chinese Health Qigong Ba Duan Jin in the treatment of patients with stable chronic obstructive pulmonary disease / 中国基层医药

Objective:To investigate the effect of traditional Chinese Health Qigong Ba Duan Jin in the treatment of patients with stable chronic obstructive pulmonary disease.Methods:From June 2017 to June 2019, 68 patients with stable chronic obstructive pulmonary disease admitted to Hangzhou Traditional Chinese Medicine Hospital were divided into control group and observation group according to the random number table method, with 34 cases in each group.The control group was treated with terbutaline sulfate and given routine interventions such as disease knowledge, diet guidance, psychological counseling, and oxygen therapy.The observation group was trained with the traditional Chinese Health Qigong Ba Duan Jin on the basis of the control group.The pulmonary function, blood gas analysis and St.George's respiratory score were measured before and after intervention.The 6-minute walking distance before and after intervention was recorded, and the clinical efficacy of the two groups was evaluated.Results:The lung function indicators of the two groups were significantly improved after intervention(all P<0.05). The improvement of lung function indexes in the observation group were significantly higher than those in the control group(all P<0.05). The PaO 2 levels of the two groups after intervention were significantly higher than those before intervention(all P<0.05). The PaO 2 levels in the observation group was significantly higher than that in the control group( P<0.05), and the PaCO 2 levels in the observation group was significantly lower than that in the control group( P<0.05). The symptoms, activity and life impact scores of the two groups were significantly lower than those before interventionp(all P<0.05). The decrease of the St.George's respiratory score in the observation group after intervention was more significant than that in the control group( P<0.05). The 6-minute walking distance of the observation group was (442.63±14.85)m, which was significantly longer than that of the control group[(417.28±13.07)m]( t=7.472, P=0.000). The total effective rate of the observation group was 88.24%(30/34), which was significantly higher than that of the control group[64.71%(22/34), χ 2=10.299, P=0.006]. Conclusion:The traditional Chinese Health Qigong Ba Duan Jin exercise combined with drugs and routine intervention can improve the lung function and blood gas index of patients with stable chronic obstructive pulmonary disease, slow down the decline of lung function, improve their exercise capacity and relieve breathing difficulties.Finally, improve the efficacy to improve their quality of life.

Clinical analysis of 110 cases of acute pulmonary embolism treated with thrombolysis / 中华急诊医学杂志

Objective:To investigate the clinical characteristics, risk stratification, thrombolytic effects and prognosis of 110 patients with acute pulmonary embolism (PE) treated with thrombolysis.Methods:The clinical data of 110 patients with PE admitted to Beijing University People's Hospital from May 2009 to March 2019 were retrospective analyzed. The clinical data including general information, symptoms and signs, blood pressure, artery blood gas, coaglulation, and radiography were collected. Inclusion criteria: high-risk and intermediate high-risk group. Exclusion criteria: intermediate low-risk and low-risk group. According to the prognosis and risk stratification, the patients were divided into survival group and non-survival group, high-risk group and intermediate high-risk group. The indicators above were compared between with χ 2 test, t test or nonparametric test where appropriate. Results:Of the 110 patients with PE, 49 patients were male and 61 female with an average age of 65±16 years old; and 12 patients were in the high-risk group and 98 in the intermediate high-risk group. The respiratory rate of the high-risk group was higher, and blood pressure, PO 2, SaO 2 before thrombolysis were more lower than the intermediate high-risk group ( P<0.05). One hundred and nine patients were treated with systemic recombinant tissue plasminogen activator (rtPA), 70 patients with 50 mg, and 39 patients with 100 mg. One patient, who was contraindicated to systemic thrombolysis (with active vagina bleeding), was treated with interventional local thrombolysis; another 5 patients treated with interventional local thrombolysis because the clinical symptom were not improved markedly. One hundred and two patients survived and 8 patients died, among which, 3 patients were in the high-risk group and 5 in the intermediate high-risk group. The age, heart rate, respiration rate of the non-survival group were higher than those in the survival group, and the PO 2 before thrombolysis, PCO 2 after thrombolysis were lower ( P<0.05). Bleeding complication were occurred in 22 patients: 18 patients with minor bleeding, such as bleeding gums, skin ecchymosis, and 4 patients with moderate-severe bleeding, such as cerebral hemorrhage, abdominal bleeding, gastrointestinal bleeding, and vagina bleeding. Thirteen of 70 patients in the 50 mg group and 9 of 39 patients in the 100 mg group occurred bleeding complication. The bleeding complication of the low dose group was lower than that of the standard dose group ( P<0.05). Conclusions:Thrombolysis is first-line therapy to high-risk PE. Thrombolysis is safe and effective in the intermediate high-risk group with a lower incidence rate of bleeding complication.

Analysis of coagulation function and prognostic factors of acute aortic dissection / 中华急诊医学杂志

Objective To investigate the clinical characteristics,coagulation function and associated prognostic factors of acute aortic dissection.Methods The clinical data of 119 patients with acute aortic dissection (AAD) admitted to Beijing University People's Hospital from November 2008 to January 2016 were analyzed.All the participants were confirmed by computed tomography angiography,and the onset time was less than 14 days.Data of blood routine test,coagulation function at the first admission were collected,and surgical intervention and prognosis were recorded.All the patients,according to the prognosis,or whether disseminated intravascular coagulation (DIC) occurred,were divided into two groups,and the differences between the two groups were compared.Logistic regression analysis was applied to analyze independent risk factors related to in-hospital death in AAD patients.Results In 119 patients with AAD,the average age was (52.9±14.2) years,with a male/female ratio of 5.3:1.Pain was the most common clinical manifestation in patients with AAD,accounting for more than 90.0％.The nature of pain was mostly expansible and/or transitive pain.Dominant DIC occurred in 13 cases (10.9％),and 7 patients died (53.8％).There were significant differences between the DIC group and non-DIC group in neutrophil/lymphocyte ratio (NLR),platelet count,fibrinogen,D-dimer,FDP,PT,APTT and mortality rate (P＜0.05).All the 16 patients in the death group were type AAAD,among which,7 patients (43.8％) developed with DIC.There were significant differences between the death group and survival group in NLR,platelet count,fibrinogen,D-dimer,FDP,PT,APTT,DIC proportion and surgical operation rate (P＜0.05).Logistic regression analysis showed that NLR and platelet count were independent risk factors of in-hospital death (P＜0.05).Conclusions D-dimer has a high diagnostic and prognosis value for AAD.The mortality increased with the activation and depletion of platelet.Once DIC occurs,the prognosis is extremely poor.NLR and platelet count are independent risk factors for in-hospital death in patients with AAD.

Effect of nursing intervention based on 6-hour resuscitation goal theory on quality of life and various functions of sepsis patients / 中国中西医结合急救杂志

Objective To explore the effect of nursing mode based on 6-hour resuscitation goal theory on various functions and quality of life of patients with sepsis. Methods One hundred and forty-two septic patients admitted to the Second Affiliated Hospital of Wenzhou Medical University from April 2016 to July 2018 were enrolled. A total of 71 patients selected to use traditional nursing intervention strategy were assigned in the routine nursing group;in the 6-hour resuscitation target theory group, 71 patients were given nursing care based on 6-hour resuscitation target theory on the basis of traditional routine nursing. The differences in oxygenation function indexes [central venous blood oxygen saturation (ScvO2), arterial partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2)], circulatory function indexes [central venous pressure (CVP), mean arterial pressure (MAP) and heart rate (HR)], renal function indexes [urine volume and serum creatinine (SCr)] before and after intervention for 6 hours were compared between the two groups of patients; at the same time, the survival rate, treatment status and life quality improvement of the two groups after 1 month of intervention were recorded. Results After 6 hours of intervention, CVP, MAP, ScvO2, PaO2, PaO2/FiO2, urine volume and quality of life scores of patients in the 6-hour resuscitation target theory group and the routine nursing group were all increased compared with those before intervention, while the HR and SCr levels were lower than those before the intervention, moreover, the changes above indexes in the 6-hour resuscitation target theory group were more significant than those in the routine nursing group [CVP (cmH2O, 1 cmH2O = 0.098 kPa): 11.89±2.94 vs. 7.33±2.37, MAP (mmHg, 1 mmHg = 0.133 kPa): 84.11±6.13 vs. 66.15±5.27, HR (bpm):89.05±6.00 vs. 102.41±5.86, ScvO2: 0.78±0.03 vs. 0.66±0.04, PaO2 (mmHg): 154.71±20.75 vs. 106.54±24.66, PaO2/FiO2 (mmHg): 364.13±38.47 vs. 331.21±33.26, urine volume (mL/h): 71.13±10.22 vs. 37.42±13.41, SCr (μmol/L): 113.10±14.35 vs. 125.12±13.87, role function scores: 87.82±4.52 vs. 71.28±4.92, cognitive function scores: 89.23±4.63 vs. 71.75±5.34, body function scores: 90.24±4.43 vs. 72.74±5.03, emotional function scores:88.92±5.71 vs. 73.42±3.48, social function scores: 94.31±2.71 vs. 75.21±4.83, all P < 0.05]. One month after intervention, the survival rate in the 6-hour resuscitation target theory group was higher than that in the routine nursing group [69.01% (49/71) vs. 42.25% (30/71), P < 0.05], compared with routine nursing group, stay time in intensive care unit (ICU) and mechanical ventilation time in the 6-hour resuscitation target theory group were significantly shortened [stay time in ICU (days): 7.34±3.31 vs. 9.42±3.60, mechanical ventilation time (days): 3.52±0.84 vs. 5.83±0.85, both P < 0.05]. Conclusion The application of nursing intervention based on 6-hour resuscitation target theory for patients with sepsis has very significant effects on promoting the patients' oxygenation, renal and circulatory functions, and improving their survival rate and quality of life.

Clinical Observation of Chinese Medicine Syndrome Differentiation Individual Therapy on Precancerous Lesions of Gastric Cancer / 中国药房

OBJECTIVE： To provide reference for clinical treatment of precancerous lesions of gastric cancer. METHODS： A total of 685 patients with precancerous lesions of gastric cancer were selected from our hospital during Jan.-Dec. 2018. Totally 455 patients in treatment group received individualized TCM therapy according to syndrome differentiation， 7 days as a course， 4 courses in total； another 230 patients in control group received Folic acid tablets， 5 mg， tid， for 2 months. The changes of pepsinogen ratio （PGⅠ/PGⅡ）， gastrin-17 （G-17） and Helicobacter pylori （Hp）before and after treatment， and the occurrence of ADR were compared between 2 groups. RESULTS： After treatment， total response rate of treatment group was 90.3％， which was significantly higher than 68.6％ of control group. PGⅠ/PGⅡ of treatment group were increased significantly， which was significantly higher than control group； G-17 levels of 2 groups were decreased significantly （P＜0.05）； there was no statistical significance in Hp level between 2 groups before and after treatment （P＞0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS： Chinese medicine syndrome differentiation individual therapy can significantly delay the development of precancerous lesions of gastric cancer， and has good safety.

Altered Local Field Potential Relationship Between the Parafascicular Thalamic Nucleus and Dorsal Striatum in Hemiparkinsonian Rats / 神经科学通报·英文版

The thalamostriatal pathway is implicated in Parkinson's disease (PD); however, PD-related changes in the relationship between oscillatory activity in the centromedian-parafascicular complex (CM/Pf, or the Pf in rodents) and the dorsal striatum (DS) remain unclear. Therefore, we simultaneously recorded local field potentials (LFPs) in both the Pf and DS of hemiparkinsonian and control rats during epochs of rest or treadmill walking. The dopamine-lesioned rats showed increased LFP power in the beta band (12 Hz-35 Hz) in the Pf and DS during both epochs, but decreased LFP power in the delta (0.5 Hz-3 Hz) band in the Pf during rest epochs and in the DS during both epochs, compared to control rats. In addition, exaggerated low gamma (35 Hz-70 Hz) oscillations after dopamine loss were restricted to the Pf regardless of the behavioral state. Furthermore, enhanced synchronization of LFP oscillations was found between the Pf and DS after the dopamine lesion. Significant increases occurred in the mean coherence in both theta (3 Hz-7 Hz) and beta bands, and a significant increase was also noted in the phase coherence in the beta band between the Pf and DS during rest epochs. During the treadmill walking epochs, significant increases were found in both the alpha (7 Hz-12 Hz) and beta bands for two coherence measures. Collectively, dramatic changes in the relative LFP power and coherence in the thalamostriatal pathway may underlie the dysfunction of the basal ganglia-thalamocortical network circuits in PD, contributing to some of the motor and non-motor symptoms of the disease.

An exploration of the training and evaluation systems of medical undergraduates in the context of tutorial system / 中华医学教育探索杂志

Objective To investigate the training process of clinical practice ability in medical undergraduates in the context of tutorial system,as well as new clinical training models and evaluation methods.Methods A total of 40 medical undergraduates who entered the stage of clinical practice were randomly divided into tutorial group and control group,with 20 undergraduates in each group.A diversified evaluation system was used to perform a comprehensive evaluation of clinical practice ability of medical undergraduates at different stages,with a combination of professional theory examination,Mini-Clinical Evaluation Exercise,Direct Observation of Procedural Skills,and clinical case report.All the data were analyzed by SPSS 23.0,t test was used for statistical analysis.Results Compared with the control group after the internship ended,the tutorial group had significantly higher scores of clinical professional theory (86.24 ± 2.93),clinical practice ability (7.53 ± 0.48),clinical operation skills (4.35 ± 0.47),and clinical thinking ability (6.31 ± 0.52) (all P＜0.05).Conclusion The application of the tutorial training mode during the internship of medical undergraduates can improve their comprehensive qualities such as professional quality,medical theory,and practical skills.The diversified evaluation system can evaluate the teaching effect and reflect the cultivation of comprehensive quality among students.

Establishment of hypoglycemia risk assessment model for elderly diabetic patients in community and its application value analysis / 中国医师杂志

Objective To construct a guidable risk assessment model to reduce hypoglycemia in elderly diabetic patients in the community in the next month,and to analyse the application value of the model to elderly diabetic patients in the community.Methods 164 elderly patients in community with diabetes were collected in December 2016,and the frequency of hypoglycemia was analysed.The independent risk factors of hypoglycemia were determined by logistic regression analysis to establish a risk assessment model.Under the guidance of the model,the changes of score in the model and incidence rate of hypoglycemia were observed.Results Independent risk factors of hypoglycemia included medication without following the doctor's advice (X1),poor exercise habits (X2),poor dietary habits (X4),body mass index over median (X8) (OR =15.927,4.145,3.040,6.032,P ＜0.05).The risk assessment model showed that risk scores =2 × X1 + 1 × X2 + 1 × X4 + 2 × X8,indicating this model had reliable diagnostic value for hypoglycemia.The area under the receiver operating characteristic (ROC) curve of this model for was 0.977,and the optimal cut-off value for the risk score was ≥4 points.After intervention,the risk score showed a downward trend (F =568.018,P =0.000),and the incidence of hypoglycemia was significantly lower than that before (P ＜ 0.05).Conclusions The evaluation model of hypoglycemia in elderly patients with diabetes in community can guide the intervention of community health care,and it can effectively reduce the incidence of hypoglycemia with great application value.

Analysis of coagulation function and prognostic factors of acute aortic dissection / 中华急诊医学杂志

Objective@#To investigate the clinical characteristics, coagulation function and associated prognostic factors of acute aortic dissection.@*Methods@#The clinical data of 119 patients with acute aortic dissection (AAD) admitted to Beijing University People's Hospital from November 2008 to January 2016 were analyzed. All the participants were confirmed by computed tomography angiography, and the onset time was less than 14 days. Data of blood routine test, coagulation function at the first admission were collected, and surgical intervention and prognosis were recorded. All the patients, according to the prognosis, or whether disseminated intravascular coagulation (DIC) occurred, were divided into two groups, and the differences between the two groups were compared. Logistic regression analysis was applied to analyze independent risk factors related to in-hospital death in AAD patients.@*Results@#In 119 patients with AAD, the average age was (52.9±14.2) years, with a male/female ratio of 5.3:1. Pain was the most common clinical manifestation in patients with AAD, accounting for more than 90.0%. The nature of pain was mostly expansible and/or transitive pain. Dominant DIC occurred in 13 cases (10.9%), and 7 patients died (53.8%). There were significant differences between the DIC group and non-DIC group in neutrophil/lymphocyte ratio (NLR), platelet count, fibrinogen, D-dimer, FDP, PT, APTT and mortality rate (P<0.05). All the 16 patients in the death group were type A AAD, among which, 7 patients (43.8%) developed with DIC. There were significant differences between the death group and survival group in NLR, platelet count, fibrinogen, D-dimer, FDP, PT, APTT, DIC proportion and surgical operation rate (P<0.05).Logistic regression analysis showed that NLR and platelet count were independent risk factors of in-hospital death (P<0.05).@*Conclusions@#D-dimer has a high diagnostic and prognosis value for AAD. The mortality increased with the activation and depletion of platelet. Once DIC occurs, the prognosis is extremely poor. NLR and platelet count are independent risk factors for in-hospital death in patients with AAD.

Effects of systematic nursing on pain, dysfunction and recovery of patients with pelvic fracture treated by screw fixation / 中国实用护理杂志

Objective To analyze the degree of pain, dysfunction and recovery of patients with systemic fractures treated by screw fixation. Methods The clinical data of 96 patients with pelvic fractures who had been diagnosed and treated in the Hospital between January 2017 and January 2018 were analyzed. All cases were treated by screw fixation, and according to the random number table, these patients were divided into two groups: the 48 patients given routine nursing were taken as the control group, whereas the other 48 given systematic nursing were included in the study group. The pain intensity, dysfunction and recovery of patients in the two groups were compared. Results The proportions of patients with severe pain and moderate pain were respectively 0 and 18.75% (9/48) in the study group, both lower than the control group, which were respectively 27.08% (13/48) and 41.67% (20/48) ( χ2=15.036 1, 5.978 4,P＜0.05), and the proportions of patients with mild pain and without pain were 52.08% (25/48) and 29.17% (14/48) in the study group, both higher than the control group, which were respectively 31.25% (15/48) and 0 (χ2=4.285 7, 16.390 2, P＜0.05). The total Oswestry Dability Index (ODI) score was (20.30±2.22) points, lower than that in the control group, which was (40.42±2.40) and the time for fracture healing, time for lying in bed and length of hospital stay in the study group were (57.20± 11.11) d and (4.30±1.20)d both shown to be shorter than the control group (69.70±13.60) d, (8.41±1.39) d (t=42.637 6, 4.931 5, 15.506 4,P<0.05). The incidence of complications in the study group was 4.17% (2/48), lower than 20.83% (10/48) in the control group ( χ2=6.095 2,P<0.05). Conclusion For patients with pelvic fractures treated by screw fixation, systematic nursing can relieve their pains, reduce dysfunction and boost their recovery, and yet incur fewer complications.