Epidemiological characteristics of latent syphilis in Yancheng Cityfrom 2016 to 2020 / 预防医学

Objective@#To analyze the epidemiological characteristics of latent syphilis in Yancheng City from 2016 to 2020, so as to provide insights into syphilis control. @*Methods@#All reported cases with latent syphilis in Yancheng City from 2016 to 2020 was collected from the Communicable Disease Report System of China Disease Prevention and Control Information System, and the prevalence of latent syphilis was estimated and standardized by the seventh population census data in Yancheng City. The trends in the incidence of latent syphilis were evaluated using annual percent change (APC), and the temporal, regional and human distributions of latent syphilis patients were descriptively analyzed. In addition, the spatial clusters of latent syphilis incidence were identified using spatial autocorrelation analysis. @*Results@#A total of 7 790 cases with latent syphilis were reported in Yancheng City from 2016 to 2020, and the standardized incidence of latent syphilis increased from 15.35/105 in 2016 to 28.70/105 in 2020 (APC=17.54%, t=5.357, P=0.013). Latent syphilis cases were reported in each month, and no obvious seasonable characteristics were seen. During the period from 2017 to 2020, the highest incidence of latent syphilis was seen in residents at ages of 70 to 79 years, with incidence rates of 41.71/105, 43.04/105, 75.79/105 and 72.94/105, respectively, and most cases were farmers (4 711 cases, 60.47%). The three highest incidence of latent syphilis was reported in Funing County (191.40/105), Tinghu District (137.13/105) and Yandu District (126.23/105). There was a positive spatial correlation of latent syphilis incidence in Yancheng City from 2016 to 2020 (Moran's I=0.23, Z=4.457, P=0.001), and two high-high clusters were identified in 14 townships (streets) of Funing County, Binhai County, Tinghu District, Sheyang County and Yandu District and 3 low-low clusters in 7 townships (streets) in Jianhu County, Tinghu District, Dongtai City and Sheyang County. @*Conclusions@#The incidence of latent syphilis appeared a tendency towards a rise, and there were remarkable spatial clusters identified in latent syphilis incidence in Yancheng City from 2016 to 2020. The elderly people and farmers are at high risk of latent syphilis.

Clinical characteristics and pathogenic spectrum of pulmonary filamentous fungal infection in acquired immunodeficiency syndrome patients in Guangdong Province / 中华传染病杂志

Objective:To investigate the clinical characteristics and pathogen spectrum of acquired immunodeficiency syndrome (AIDS) patients complicated with pulmonary filamentous fungal infection in Guangdong Province, so as to provide evidences for improving the diagnosis and treatment.Methods:A total of 143 AIDS patients with pulmonary filamentous fungal infection hospitalized in Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 2016 to December 2018 were included. The filamentous fungi cultured in bronchoalveolar lavage fluid of these patients were identified with morphological and molecular biological methods. And their clinical characteristics were analyzed. Nonparametric Kruskal-Wallis H test and chi-square test were used for statistical analysis. Results:Among the 143 patients, 116(81.1%) had fever, 104(72.7%) had cough, 83(58.0%) had expectoration, and 59(41.3%) had anhelation. The CD4 + T lymphocyte count was 22.0(9.3, 60.8) cells/μL and 118(82.5%) cases were below 100.0 cells/μL. The white blood cell counts decreased in 52(36.4%) cases and increased in 18(12.6%) cases, anemia was found in 109(76.2%) cases, platelet count decreased in 29(20.3%) cases. Sixty-four (44.8%) cases were positive for galactomannan test. Chest computed tomography showed diffuse infection of both lungs in 114(79.7%) cases, miliary changes in 12(8.4%) cases, pleural effusion in 44(30.8%) cases, and enlargement of pleural and (or) mediastinal lymph nodes in 45(31.5%) cases. After receiving antifungal therapy, 124 (86.7%) cases were cured or improved, and 19 (13.3%) cases were discharged automatically or died of disease deterioration. Among the 143 strains of filamentous fungi, there were 56 strains of Aspergillus species pluralis (39.2%, including 24 strains of Aspergillus fumigatus), 37 strains of Talaromyces marneffei ( T. marneffei) (25.9%), 22 strains of Penicilium species pluralis (15.4%), and 28 strains of other genera of filamentous fungi (19.6%). The median CD4 + T lymphocyte counts in patients infected with Aspergillus species pluralis, T. marneffei, Penicilium species pluralis and other genera were 24.5, 15.0, 53.5 and 22.0 cells/μL, respectively, and the difference was statistically significant ( H=11.282, P=0.010). The proportions of AIDS patients with different pulmonary filamentous fungal infection of CD4 + T lymphocyte count ≤50.0 cells/μL in descending order were T. marneffei group (89.2%(33/37)), Aspergillus species pluralis group and other genera group (67.9%(38/56), 67.9%(19/28)), and Penicillium species pluralis group (54.5%(12/22)), and the difference was statistically significant ( χ2=9.296, P=0.026). Conclusions:The clinical manifestations of pulmonary filamentous fungal infection in AIDS patients in Guangdong Province are not specific. The pathogenic spectrum contains various genera, and T. marneffei and Aspergillus fumigatus are dominant, which could be correlated with CD4 + T lymphocyte count.

Application of integrated teaching mode in clinical clerkship of obstetrics and gynecology / 中华医学教育探索杂志

Objective:To explore the value of series situational simulation teaching combined with symptoms-centered integrated teaching mode in clinical clerkship of obstetrics and gynecology.Methods:A total of 181 students from Batch 2016 of Clinical Medicine (experimental group) were enrolled to receive the series situational simulation teaching combined with symptoms-centered integrated teaching mode. The teaching results were evaluated by formative evaluation scores and questionnaire, compared with 195 students from Batch 2015 (control group). The statistical analysis was performed with SPSS 21.0.Results:Scores of formative evaluation in experimental group [(88.66±5.92) points] was higher than those in control group [(81.11±7.36) points], with statistically significant differences ( P<0.05). Satisfaction of students for teaching flexibility, teaching innovation, learning interest and clinical thinking in experimental group was greater than that of students in control group ( P<0.05). Meanwhile, compared with the control group, teachers from experimental group were more satisfied with teaching flexibility, teaching integration, students' participation and activity in classroom and cultivation of the clinical thinking ability and post competences ( P<0.05). Conclusion:The series situational simulation teaching combined with symptoms-centered integrated teaching mode can help students to form a systemic knowledge system, cultivate their clinical thinking ability and establish a holistic view of disease.

Prevention and treatment of complications in the treatment of femoral shaft closed fracture with core drilling intramedullary nail / 中国骨伤

OBJECTIVE@#To summarize the complications of core drilling intramedullary nail in the treatment of femoral shaft closed fracture and explore the treatment strategy.@*METHODS@#From August 2014 to June 2018, a total of 215 patients with closed femoral shaft fractures were treated with closed reduction core drill intramedullary nail, including 129 males and 86 females, aged from 18 to 62 years, with an average of (44.2±10.6) years old. The time from injury to operation was 3 to 21 days. There were 102 cases of AO type A fracture, 82 cases of AO type B fracture and 31 cases of AO type C fracture. The time of operation, the amount of blood loss during operation, the duration of hospitalization, the time of fracture healing and the HSS score of knee joint function at the last follow-up were recorded. The observation of complications included:iatrogenic fracture, core drill broken, core drill twist, postoperative infection, and fracture nonunion.@*RESULTS@#The average operation time was (63.2± 15.6) min and intraoperative blood loss was (150.0±34.5) ml. All the incisions reached grade A healing. Patients were follow up for a mean of (18.5±3.2) months, the average hospital stay was (4.3±1.2) days, and the average fracture healing time was (5.6±2.3) months. At the final follow-up, the average HSS score of knee joint was 90.3±4.7. Related complications occurred in 37 cases (17.2%). The core drill related complications occurred in 13 cases (6.0%), including core drill broken in 5 cases (2.3%), core removal in 1 case and slotting in 4 cases;core drill twist in 8 cases (3.7%). After the core was cut, the core was removed. Similar complicationsof conventional intramedullary nail:iatrogenic fracture was performed in 12 cases (5.6%), including 10 cases of fracture end split and 2 cases of distal perimedullary fracture of intramedullary nail. The patients with cleavage at the fracture end were not treated after judging their stability, and the patients with fracture around the distal end of the intramedullary nail were fixed with auxiliary steel plate during operation;1 case(0.4%) with delayed infection after operation, debridement and external fixation was replaced and healed after bone transfer; fracture nonunion occurred in 11 cases (5.1%), of which 7 cases (3.3%) were hypertrophic nonunion and healed with additional plate. Atrophic nonunion occurred in 4 cases (1.9%), which healed after additional steel plate and bone graft.@*CONCLUSION@#Core drilling intramedullary nail is an effective method for the treatment of closed femoral shaft fracture, and the complications include core drill related complications and conventional intramedullary nail similar complications. Accurate preoperative evaluation, careful operation during operation and early postoperative symptomatic treatment can effectively reduce the occurrence of related complications.

Effects of Ziziphi Spinosae Semen and Albiziae Flos on Behavior and Endoplasmic Reticulum Stress PERK/ATF4/CHOP Pathway in Depression Model Rats / 中国实验方剂学杂志

Objective:To investigate the effect of Ziziphi Spinosae Semen （ZSS） and Albiziae Flos （AF） on behavior and endoplasmic reticulum stress endoplasmic reticulum stress protein kinase R-like endoplasmic reticulum kinase （PERK）/activated transcription factor 4 （ATF4）/CCAAT enhancer binding protein （CHOP） pathway in depression model rats， and to explore its antidepressant mechanism. Method:The male SD rats were divided into normal group， model group， ZSS-AF high dose， middle dose and low dose groups （16， 8， 4 g·kg^-1） and Venlafaxine group （0.008 g·kg^-1）， <italic>n</italic>=15 in each group. Except the normal group， the depression model was established in the rats of other 5 groups by the method of chronic unpredictable mild stress （CUMS） combined with isolated feeding. The normal group and model group were given with distilled water by gavage when modeling， while other groups received corresponding drug by intragastric administration for 21 days. Behavior changes of rats in each group were observed by the open field test and sugar water consumption test on 1^thand 21^thday of the experiment. The protein expressions of PERK， CHOP， B-cell lymphoma-2 associated X protein （Bax） and cysteine-containing aspartate-specific proteases-3（Caspase-3） were detected by Western blot（WB）， the ultrastructural changes of the hippocampus were observed by transmission electron microscope， the apoptosis of hippocampal neurons was observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL） method. Result:Compared with the normal group， the scores of open field test and sugar water consumption rate in model group rats decreased （<italic>P</italic><0.01）. Compared with the model group， the scores of open field test and water consumption rate increased （<italic>P</italic><0.01） in ZSS-AF groups and Venlafaxine group. Transmission electron microscope showed that the changes of neuronal damage in hippocampal were revealed in the model group， whereas those neuronal damages were relieved in ZSS-AF groups and Venlafaxine group. TUNEL method showed that the number of apoptotic neurons in hippocampal increased in the model group （<italic>P</italic><0.01）， but decreased in ZSS-AFgroups and Venlafaxine group （<italic>P</italic><0.01）. WB results showed that as compared with the normal group， protein expressions of PERK， CHOP， Bax and Caspase-3 were up-regulated significantly in the model group （<italic>P</italic><0.01）， whereas those were down-regulated in ZSS-AF groups and Venlafaxine group （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:The antidepressant effect of ZSS-AF herbal pair may be correlated with the regulation of endoplasmic reticulum stress PERK/ATF4/-CHOP pathway.

Anxiety and depression status and influencing factors among junior high school students in Nanqiao， Fengxian District， Shanghai / 上海预防医学

Objective:To analyze the current status of anxiety/depression and the influencing factors in junior high school students in Nanqiao Town， and to provide the objective evidence for relevant departments to promote the mental health of junior high school students. Methods:The stratified cluster sampling was used in this study. A total of 1 154 junior high school students from 4 out of 7 schools in Nanqiao Town were selected to participate in the survey. A self-designed questionnaire was used to collect basic information. The Chinese Middle School Students Anxiety Scale and the Chinese Middle School Students Depression Scale were used to assess anxiety and depression. Results:The detection rates of anxiety and depression in junior high school students in Nanqiao Town were 27.3%（298/1 092） and 12.6%（138/1 092）， respectively. The detection rates of anxiety and depression in boys were 25.9%（147/568） and 12.2%（69/568）， respectively， while the rates in girls were 28.8%（151/524） and 13.2%（69/524）. There was no statistical difference between genders （χ2= 1.184，0.257， All P<0.05）. With gradual increase in grade， the detection rate of depressive symptoms also gradually increased （χ2=12.393，P<0.05）. Multivariate logistic regression analysis showed that the independent factors of anxiety were： foreign household registration （OR=2.2）， low learning interest （OR=3.8）， self-perceived learning pressure （OR=14.5） or moderate learning pressure （OR=3.8）， average personality （OR=1.5）， poor relationship with parents （OR=2.2）， and normal relationship with family （OR=2.0）. The independent influencing factors of depression included： moderate learning interest （OR=2.8） or low （OR=11.1）， self-consciousness high learning pressure （OR=4.1）， average personality （OR=1.9）， average relationship with family members （OR=2.0） or poor relationship with family members （OR=6.5）， and poor relationship with classmates and friends （OR=10.4）. Conclusions:The mental health of junior high school students in Nanqiao Town needs further improvement. We should focus on students who are foreign students and/or experience high learning pressure， introverted personality， and tension in interpersonal relationships， anxiety and depression.We should also carry out related health activities and intervention measures to improve students' psychological adjustment ability and promote their physical and mental health.

Association between childhood abuse and recent negative life events with suicidal psychological behavior of middle school students / 中国学校卫生

Objective@#To investigate the relationship between childhood abuse and recent negative life events with suicidal ideation and attempt, and to provide reference for prevention and control of suicidal behaviors in middle school students.@*Methods@#Stratified cluster sampling method was used to select 7 986 middle school students from Shenzhen, Nanchang and Shenyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse, negative life events, suicidal ideation and suicide attempt, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and negative life events with suicidal ideation and suicide attempt.@*Results@#The prevalence of suicidal ideation and suicide attempt was 22.9% and 4.7%. After adjusted for confounding variables, with the increase of childhood abuse and negative life events, suicidal ideation and attempt in middle school students showed an increasing trend(P<0.05). Compared those with low level of childhood abuse and negative life events, students with high childhood abuse and high negative life events had a higher suicidal ideation and suicide attempt risk, the multiple adjusted odds ratio was 10.43 and 19.75(P<0.05).@*Conclusion@#Childhood abuse and negative life events are important risk factors affecting suicidal ideation and attempt in middle school students. Strategies to reduce childhood abuse and negative life events should be an integral component of targeted mental health interventions.

Application value of laparoscopic technology in reoperation of locally recurrent rectal cancer / 中华消化外科杂志

The incidence of locally recurrent rectal cancer is about 10%. Most patients have serious symptoms after tumor recurrence, which seriously affects the quality of life and prognosis of patients. Although it is more difficult to perform reoperation, it is still the main method to treat local recurrence of rectal cancer. At present, the main methods of reoperation include transabdominal anterior resection, combined pelvic organ resection, combined pelvic organ resection, and sacral resection. Open surgery is the main method. In recent years, with the extensive development of laparoscopic technology, laparoscopic techniques have been tried at home and abroad to perform reoperations for locally recurrent rectal cancer, showing good short-term results. The authors systematically introduce the application of laparoscopic technology in the reoperation of locally recurrent rectal cancer based on relevant research advances at home and abroad, in order to explore its clinical application prospects and promotion value.

Clinical study of movable external fixation for elbow tuberculosis / 中国骨伤

OBJECTIVE@#To compare clinical effect of movable external fixation and fusion fixation for the treatment of elbow tuberculosis.@*METHODS@#From October 2013 to June 2019, 52 patients with elbow tuberculosis treated with standard antituberculosis therapy were divided into movable external fixation group and fusion fixation group according to treatment methods. In group A, there were 25 patients, including 11 males and 14 females, aged from 24 to 75 years old with an average of (42.81± 9.01) years old; the courses of diseases ranged from 2 to 9 months with an average of (3.96±1.45) months. In group B, there were 27 patients, including 15 males and 12 females, aged from 23 to 77 years old with an averageof (44.08±7.44) years old; the courses of diseases ranged from 2 to 7 months with an average of (3.88±1.67) months. All patients were performed focus debridement. Intraoperative blood loss, operative time were compared between two groups. VAS score before operation, 2 weeks and 12 months after operation were applied to evaluate pain relieve;Mayo elbow performance score (MEPS) before operation, 1 and 12 months after operation were used to evaluate clinical effect;changes of erythrocyte sedimentation rate (ESR) and Creactive protein, CRP) before operation, 3 weeks after antituberculosis therapy, 1 week and 6 months after operation were compared between two groups.@*RESULTS@#All patients were followed up from 12 to 20 months with an average of (13.50±4.85) months. No mixed infection and recurrence of tuberculosis occurred. There were no statistical differences in intraoperative blood loss and operative time(@*CONCLUSION@#For elbow tuberculosis, movable external fixation and fusion fixation have equal effect in operative time, amount of bleeding and control of tuberculosis infection indicator. Movable external fixation need earlier functional exercise, not conducive to pain relief at early stage, which may be better than fusion fixation, it is worth clinical promoting.

The efficacy and safety of lopinavir/ritonavir and arbidol in patients with coronavirus disease 2019 / 中华内科杂志

Objective:To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in treating patients with coronavirus disease 2019 (COVID-19) in the real world.Methods:The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were retrospectively analyzed. According to patient′s antiviral treatment regimens, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), LPV/r plus arbidol combination group (25 patients) and the supportive care group without any antiviral treatment (58 patients). The primary end point was the negative conversion time of nucleic acid of 2019 novel coronavirus (2019-nCoV) by pharyngeal swab.Results:The baseline parameters of 4 groups before treatment was comparable. The negative conversion time of viral nucleic acid was (10.20±3.49), (10.11±4.68), (10.86±4.74), (8.44±3.51) days in LPV/r group, arbidol group, combination group, and supportive care group respectively ( F=2.556, P=0.058). There was also no significant difference in negative conversion rate of 2019-nCoV nucleic acid, the improvement of clinical symptoms, and the improvement of pulmonary infections by CT scan ( P>0.05). However, a statistically significant difference was found in the changing rates from mild/moderate to severe/critical type at day 7 (χ 2=9.311, P=0.017), which were 24%(6/25) in combination group, 16.7%(6/36) in arbidol group, 5.4%(3/56) in LPV/r group and 5.2%(3/58) in supportive care group. Moreover, the incidence of adverse reactions in three antiviral groups was significantly higher than that in supportive care group (χ 2=14.875, P=0.002). Conclusions:Antiviral treatment including LPV/r or arbidol or combination does not shorten the negative conversion time of 2019-nCoV nucleic acid nor improve clinical symptoms. Moreover, these antiviral drugs cause more adverse reactions which should be paid careful attention during the treatment.

Medial patellofemoral ligament reconstruction with autologous long fibular muscle tendon under arthroscopy for treatment of patellar dislocation / 中华创伤杂志

Objective:To evaluate the clinical efficacy of medial patellofemoral ligament (MPFL) reconstruction with autologous long fibular muscle tendon assisted by arthroscope for treatment of patellar dislocation.Methods:A retrospective case series study was carried out to analyze data of 15 patients with patellar dislocation treated from February 2016 to June 2018 at Affiliated Hospital of Nantong University. There were 6 males and 9 females with an average age of 26.8 years (range, 14-46 years). All patients had lateral patellar dislocation, including 14 patients with recurrent patellar dislocation and 1 with habitual dislocation. All patients underwent arthroscopic exploration and MPFL reconstruction with autologous long fibular muscle tendon, among which 12 underwent arthroscopic lateral retinacular release simultaneously, 3 underwent MPFL reconstruction only. Operation duration, incision healing, function of ankle joint, extrapolation test, extrapolation apprehension test, and complications were recorded. Knee joint function was assessed using Lysholm score, Kujala score, and International Knee Documentation Committee (IKDC) score before operation, at postoperative 6 months and at latest follow-up.Results:All patients were followed up for 9-33 months with an average of 24.2 months. The operation duration was 65-85 minutes (average 71.2 minutes). All incisions healed by first intention. Ankle joint function was satisfying without pain and discomfort. At the latest follow-up, no recurrent dislocation of patella occurred, with negative results of the extrapolation test and extrapolation apprehension test at 20 degrees flexion of knee. Six months after surgery, the patients completely returned to normal activities. The Lysholm scores, Kujala score and IKDC score were improved from preoperative (51.7±2.5)points, (52.8±3.3)points, (47.1±3.3)points to (84.6±3.2)points, (85.0±3.3)points, (82.5±2.0)points respectively at postoperative 6 months, and to (89.5±1.9)points, (89.2±2.8)points, (87.5±2.2)points respectively at the latest follow-up ( P<0.01). Conclusions:MPFL reconstruction with autologous long fibular muscle tendon assisted by arthroscope, supplemented by lateral retinacular release, can attain curative effect for patellar dislocation and ameliorate knee function.

One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion for the treatment of lumbosacral tuberculosis / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion for the treatment of lumbosacral tuberculosis.@*METHODS@#The clinical data of 31 patients with lumbosacral tuberculosis treated by one-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion from January 2013 to February 2018 were retrospectively analyzed. There were 18 males and 13 females, aged from 18 to 77 years old with an average of (45.9±9.1) years. The lesion segment was form L to S. The preoperative ASIA grading showed that 2 cases were grade B, 17 cases were grade C, 12 were grade D. Pre- and post-operative C reactive protein (CRP), visual analogue scale (VAS), erythrocyte sedimentation rate (ESR), ASIA grade, lumbosacral angle and intervertebral space height were analyzed, the surgery complications, stability of internal fixation, bone fusion were observed.@*RESULTS@#All the 31 patients were followed up for 10 to 24 months with an average of (16.0±3.1) months. One patient with local infection and subcutaneous hydrops was cured by dressing change. Other 30 cases got primary healing without sinus formation and no recurrence of spinal tuberculosis. All the patients were cured, no internal fixation loosening and breakage were found. All bone fusion was successful with an average fusion time of (4.7±1.1) months. At the final follow-up, ESR and CRP were normal, the VAS was decreased from (6.13±1.21) points preoperatively to (1.92±0.57) pioints, the ASIA grading showed that 2 cases were grade C, 6 cases were grade D, and 23 cases were grade E. The lumbosacral angle and intervertebral space height was increased from preoperative (21.42±3.75) °, (7.84±0.41) mm to (27.21±3.12) °, (9.80±0.38) mm at the final follow-up, respectively.@*CONCLUSION@#One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion is a practicable, effective and safe method for the treatment of lumbosacral tuberculosis. It can be recommended in clinical application.

The clinical significance of diagnosis and therapy in patients with adult bronchial asthma by fractional exhaled nitric oxide levels / 中国基层医药

Objective@#To evaluate the sensitivity and specificity of exhaled nitric oxide in the diagnosis and therapy of bronchial asthma.@*Methods@#From January 2016 to December 2017, 87 patients diagnosed with bronchial asthma in Luoyang Central Hospital Affiliated to Zhengzhou University were selected as asthma group , and 40 healthy people were selected as healthy control group at the same term.The levels of FeNO, FEV1/pred, peripheral blood EOS count, ACT score, percentage of sputum EOS were measured.@*Results@#The positive rate of FeNO was 56.3%(49/87) in the asthma group, which in the healthy control group was 5.0%(2/47). The fractional exhaled nitric oxide level of reexamined patients before treatment [(70.9±53.6)ppb] was higher than that after treatment[(12.2±8.7)ppb], and the difference was statistically significant(t=4.323, P=0.001). The fractional exhaled nitric oxide level in the asthma group [(42.4±42.5)ppb] was higher than that in the healthy control group [(9.4±5.8)ppb], and the difference between the two groups was statistically significant(t=2.871, P=0.001). The fractional exhaled nitric oxide level was positively correlated with peripheral blood EOS count (r=0.376, P=0.000) and ACT score (r=0.361, P=0.001), but had no correlation with FEV1/pred (r=-0.111, P=0.306) and sputum EOS (r=-0.036, P=0.805).@*Conclusion@#The measurement of fractional exhaled nitric oxide levels has an important clinical significance in the diagnosis of bronchial asthma.And it has a guiding significance for the evaluation of the therapeutic effect of bronchial asthma.

Curative application analysis of single-pass four-throw pupilloplasty in combined surgery of cataract and glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the application effect of single-pass four-throw pupilloplasty in combined surgery of cataract and glaucoma.<p>METHODS: Twenty eight patients(30 eyes)suffered from acute attack of glaucoma with large pupil and cataract, received cataract phacoemulsification and intraocular lens implantation combined with angle separation or trabeculectomy and single-pass four-throw pupilloplasty in apllication. Preoperative and postoperative visual acuity, pupil diameter and complications were observed, and postoperative visual quality were measured.<p>RESULTS: The visual acuity of 7d after operation was significantly improved without double vision and glare. The preoperative pupil diameter was 5.9+0.25mm, and the postoperative was 4.1±0.13mm(<i>P</i><0.05). Postoperative visual quality was significantly improved(<i>P</i><0.05). Among the intraoperative complications, there were 5 cases 5 eyes of iridodelamination avulsion after suture, 1 case 1 eye of small holes near the formed pupil and 3 cases 3 eyes of small blood seepage at the iris root, which recovered well after the corresponding treatment. The inflammation of anterior chamber were common at the early postoperative period, and inflammatory absorption after anti-inflammatory treatment. Long-term observation showed no loosening or shedding of the line knot in the pupil area.<p>CONCLUSION: Single-pass four-throw pupilloplasty is simple, safe and effective. It can obviously eliminate the visual impairment caused by the large pupil after acute glaucoma attack.

Morphology of A1 segment of anterior cerebral artery and anterior communicating artery aneurysms / 国际脑血管病杂志

Anterior communicating artery aneurysms (ACoAA) accounts for about 30% of all intracranial aneurysms, and their occurrence and morphology are closely related to A1 segment of anterior cerebral artery. The dominant blood supply of A1 segment of unilateral anterior cerebral artery and the angle between A1 segment and A2 segment are important factors for the formation and development of ACoAA. The aneurysmal orientation of ACoAA is closely related to the morphological features of the A1 segment of the dominant anterior cerebral artery. The morphology of the A1 segment of anterior cerebral artery has an important effect on treatment and outcome of ACoAA.

The clinical significance of diagnosis and therapy in patients with adult bronchial asthma by fractional exhaled nitric oxide levels / 中国基层医药

Objective To evaluate the sensitivity and specificity of exhaled nitric oxide in the diagnosis and therapy of bronchial asthma.Methods From January 2016 to December 2017,87 patients diagnosed with bronchial asthma in Luoyang Central Hospital Affiliated to Zhengzhou University were selected as asthma group ,and 40 healthy people were selected as healthy control group at the same term.The levels of FeNO,FEV1/pred,peripheral blood EOS count,ACT score,percentage of sputum EOS were measured.Results The positive rate of FeNO was 56.3% (49/87) in the asthma group,which in the healthy control group was 5.0% (2/47).The fractional exhaled nitric oxide level of reexamined patients before treatment [(70.9 ± 53.6) ppb] was higher than that after treatment[(12.2 ± 8.7)ppb],and the difference was statistically significant(t=4.323,P=0.001).The fractional exhaled nitric oxide level in the asthma group [( 42. 4 ± 42. 5 ) ppb] was higher than that in the healthy control group [( 9. 4 ± 5.8)ppb],and the difference between the two groups was statistically significant(t=2.871,P=0.001).The frac-tional exhaled nitric oxide level was positively correlated with peripheral blood EOS count (r=0.376,P=0.000) and ACT score (r=0.361,P=0.001),but had no correlation with FEV1/pred (r= -0.111,P=0.306) and sputum EOS ( r = -0.036,P =0.805). Conclusion The measurement of fractional exhaled nitric oxide levels has an important clinical significance in the diagnosis of bronchial asthma.And it has a guiding significance for the evaluation of the therapeutic effect of bronchial asthma.

Safety of percutenous coronary intervetion and risk of death in ≥85 years old patients / 中华老年心脑血管病杂志

Objective To assess the safety of PCI and risk of death in ≥85 years old patients.Methods Ninety ≥85 years old coronary heart disease patients after PCI were included in this study.The risk of death on day 30 after PCI and during the follow-up period was assessed according to their surgical access,preoperative and postoperative estimated glomerular filtration rate (eGFR) and bleeding events,NCDR risk score of CHD.The patients were followed up for 693±510 days.Results Eighty-four patients (93.3％) underwent PCI via the radial artery.The dose of contrast media was 128.3±55.8 ml.No significant difference was found in preoperative and postoperative eGFR (55.53 ± 19.58 ml/min · 1.73 m2 vs 55.40± 18.84 ml/min · 1.73 m2,t =0.095,P=0.925).Bleeding occurred in 4 patients (4.4％) with no life-threatening massive bleeding occurred.The risk of death increased in patients with their NCDR risk score ＞45 on day 30 after PCI (P=0.013).Conclusion PCI is a safe and feasible procedure and NCDR risk score can predict the risk of death in ≥85 years old patients on day 30 after PCI.

Application of primary PCI in elderly patients with AMI / 中华老年心脑血管病杂志

Objective To assess the feasibility,safety and efficacy of primary PCI in elderly patients with AMI.Methods Three hundred and sixty-four AMI patients were divided into ≥75 years old group (n=90) and ＜75 years old group (n=274).The successful operation rate,preoperative complication rate,mortality and incidence of major adverse cardiovascular events (MACE) were recorded during their hospital stay time.Results The successful operation rate was 94.4％,the postoperative TIMI 3 blood flow rate was 87.8％,and the preoperative complication rate was 10.0 ％ in ≥75 years old group.The mortality and incidence of MACE were significantly higher in ≥75 years old group than in＜75 years old group during the hospital stay time (12.2％ vs 2.9％,P =0.001;16.7 ％ vs 5.1％,P =0.000).Conclusion Transradial primary PCI is a safe,feasible and effective therapy for ≥75 years old AMI patients.

Discussion on Research Focus of Ethical Review of Traditional Chinese Medicine Based on Co-Word Clustering Analysis Method / 中国医学伦理学

Objective: To tease relevant research on the ethical review of Traditional Chinese medicine in Chi-na and reveal hot topics and trends in the field.Methods: Taking the academic papers included in the domestic database on ethical review of Traditional Chinese medicine as literature samples,the BICOMB and SPSS22.0 soft-ware were used for document information mining,and the high-frequency keywords were analyzed used co-word clustering and thematic strategic diagram.Results: A total of 78 documents were retrieved,and 17 high-frequen-cy keywords were used.The four major hotspots in the field of ethical review of Traditional Chinese medicine in-cluded: institution building and system certification,GCP ethics optimization,ethical principle research,trial scheme design and project quality management.Conclusion: In recent years,the ethical review of Traditional Chi-nese medicine has been explored by scholars and institutions in China from multiple perspectives,and further re-search can be strengthened combined with the current weak areas,in order to increase the overall level of ethical review of Traditional Chinese Medicine.

Evaluating two methods of digital photography in retinopathy screening / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To evaluate the advantages of non - mydriatic fundus photography (NMFCS) and mydriatic fundus photography (MFCS) as eye - bottom screening and diagnosis methods in compared with gold standard fluorescein fundus angiography (FFA). ·METHODS: A total of 276 patients which involved in Chronic Diabetes Management Achieves within 4 streets of Pudong District Shanghai, were enrolled for diabetic retinopathy (DR) examination including NMFCS, MFCS and FFA. These DR examinations were proceeded after vision,slit-lamp and dioptroscopy tests,and reported by professionals. For those with suspicious fundus diseases, we would make appointments with specialist for further treatment. ·RESULTS: A total of 1104 colorful fundus images, and 1056 images (95.65%) could be used to analyze. There were 408 appreciable images, 116 basically appreciable images and 28 unusable images in 552 NMFCS images. In addition,there were 432 appreciable images,100 basically appreciable images and 20 unusable images in 552 MFCS images. There was no significant differences between NMFCS and MFCS (P>0.05). Compared with FFA with DRⅠ as the critical value, the specificity of digital photography for NMFCS was 95.71%, the sensitivity was 93.56%;however, MFCS are 95.43% and 98.02%. There was no statistically significant difference between the two screening methods (P>0.05). Compared with FFA with DR Ⅱ as the critical value, the specificity of digital photography for NMFCS was 95.35% and the sensitivity was 93. 44%; however, for MFCS were 95. 81% and 98.36%. There was no statistically significant difference between the two screening methods (P>0.05). ·CONCLUSION: Both NMFCS and MFCS could be used for the diagnosis and screening for eye diseases. NMFCS is easier and faster for digital photography, which is suitable for mass screening. MFCS is more likely to provide detailed information about the follow-up of the disease.