Acupuncture for delayed sleep-wake phase disorder: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for delayed sleep-wake phase disorder (DSWPD).@*METHODS@#A total of 84 patients with DSWPD were randomized into an observation group (42 cases, 2 cases dropped off) and a control group (42 cases, 3 cases dropped off). On the basis of sleep hygiene education, acupuncture was applied at Shenmai (BL 62), Zhaohai (KI 6), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, while placebo acupuncture was applied at the same acupoints in the control group. The treatment lasted for 8 weeks, once every other day, 3 times a week in the 1st to 4th weeks; once every 3 days, 2 times a week in the 5th to 8th weeks. Before and after treatment, the actigraphy (ACT) indexes of objective sleep (total time of stay in bed, total sleep time, sleep efficiency, the number of awakenings and the wake time after falling asleep) and plasma cortisol (CORT) level were observed; before and after treatment and in follow-up of 1, 3 months after treatment, the scores of morningness-eveningness questionnaire (MEQ), insomnia severity index (ISI), fatigue severity scale (FSS) and Epworth sleepiness scale (ESS) were observed in the two groups.@*RESULTS@#Compared before treatment, the total sleep time was prolonged, the sleep efficiency was improved, the number of awakenings was reduced, and the wake time after falling asleep was shortened after treatment in the observation group (P<0.01, P<0.05), and those in the observation group after treatment were superior to the control group (P<0.01, P<0.05). Compared before treatment, the MEQ scores after treatment in both groups and in the follow-up of 1, 3 months after treatment in the observation group were increased (P<0.01), and the MEQ score of each time point after treatment in the observation group was higher than the control group (P<0.01). The scores of ISI, FSS and ESS after treatment, and the scores of ISI、ESS in follow-up of 1, 3 months after treatment in the observation group were decreased compared with those before treatment (P<0.01, P<0.05), and in the observation group, the scores of ISI, FSS and ESS of each time point after treatment were lower than those in the control group (P<0.01, P<0.05). After treatment, the plasma CORT level in the observation group was decreased compared with that before treatment and that in the control group (P<0.01, P<0.05).@*CONCLUSION@#Acupuncture can improve the sleep and wake phase of patients with DSWPD, improve sleep quality and daytime function, and its mechanism may be related to the down-regulation of plasma CORT level.

Application of WeChat platform combined with the flipped classroom in the teaching of fever clinic resident doctors / 中华医学教育探索杂志

Objective:To explore the role of WeChat platform combined with flipped classroom in improving the working ability of resident doctors in the fever clinic.Methods:A total of 118 resident doctors who rotated in the fever clinic of department of emergency medicine were selected as the study subjects, and they were randomized into experimental group and control group, with 59 people in each group. The experimental group used WeChat platform and flipped classroom teaching, and the control group used traditional teaching. The results of theory assessment, operation performance and questionnaire survey were compared between the two groups. SPSS 26.0 statistical software was used for t test and chi-square test. Results:There was no significant difference in theoretical test scores between the experimental group and the control group ( P>0.05). The experimental group scored (91.61±3.01) points and the control group scored (84.52±4.02) points in operational assessment, with significant differences ( t=-10.85, P<0.05). The results of the satisfaction survey showed that there was no significant difference in teaching time distribution between the two groups, and the experimental group was better than the control group in any other aspects. Conclusion:The use of WeChat platform combined with flipped classroom during the COVID-19 epidemic can improve the level of operational skills of the resident doctors to wear or take off the protective clothing and collect nasopharyngeal swabs, help residents to avoid the infections, and improve the level of daily diagnosis and treatment of fever clinic.

Fruit variation and geographical distribution of citron / 中国中药杂志

The ripe dried fruit of citron(Citrus medica) is one of the important sources of Chinese herb Citri Fructus. At the same time, it is also grown for edible and ornamental uses. There are many species and abundant genetic variation. To clarify the intraspecific variation and resource distribution of citron, this study investigated the variation in 11 citron fruits, basically covering the main species in China, including Xiaoguo citron(C. medica var. ethrog), Goucheng(C. medica var. yunnanensis), Muli citron(C.medica var. muliensis), Dehong citron(C.medica×Citrus spp.), Fuzhou citron(C.medica×C.grandis?), Mawu(C.medica×C.grandis?), Cangyuan citron, Binchuan citron, Sweet citron, Big citron, and Small citron. The natural communities of citron were proved to be mainly distributed in the southwestern and western Yunnan and southeastern Tibet of China, with Yunnan, Sichuan, Guangxi, Chongqing, Hubei, and Zhejiang identified as the main production areas. Citron has also been widely grown in India, the Mediterranean region, and the Caribbean coast countries. The field investigation revealed the large-scale intraspecific variation of citron fruits. Most of the fruits are oval-like or sphere-like in shape. The fruits are green when raw and yellow when ripe, with oil cell dots on the skin, stripe-likes running from top to bottom, and bulge at the top. Usually, in the smaller citron fruits, the pulp and juice vesicles are better developed and the central columella is tighter. By contrast, the juice vesicles and central columella in larger fruits became more vacant, with carpels visible, and the apex segregation and development of the carpels is one of the reasons for variation. These variations should be given top priority in the future variety selection and breeding, and the quality differences of different citron species and their mechanisms should be further studied. In particular, variety selection and classification management according to their medicinal or edible purposes will provide scientific and technological supports for the orderly, safe, and effective production of citron products consumed as food and medicine.

Clinical study on treatment of facial seborrheic dermatitis with intense pulsed light combined with 30% supramolecular salicylic acid

OBJECTIVES: In this study, we investigated the effects of intense pulsed light (IPL) combined with 30% supramolecular salicylic acid on facial seborrheic dermatitis. METHODS: A total of 45 patients with mild or moderate facial seborrheic dermatitis were selected from our hospital between September 2018 and September 2019. The patients were divided into three groups consisting of 15 patients each. The first group was exposed to a combination of IPL and 30% supramolecular salicylic acid treatment, the second group was exposed to the IPL treatment alone, and the third group was exposed to the 30% supramolecular salicylic acid treatment alone. They were treated once every 4 weeks in three consecutive rounds. RESULTS: Facial lesions and symptoms were observed 4 and 12 weeks after the first treatment, and adverse reactions were recorded. The combination group showed significant improvement in symptoms 4 weeks after the first treatment, while the individual treatment groups showed no significant improvement. After three rounds of treatments, seborrheic dermatitis had significantly decreased in the three groups; the efficacy of the combined treatment group was significantly higher than that of the IPL group and the 30% supramolecular salicylic acid group. CONCLUSION: IPL combined with 30% supramolecular salicylic acid was effective in the treatment of facial seborrheic dermatitis and provided a quicker result with no adverse reactions.

Clinical efficacy of vacuum sealing drainage combined with topical oxygen therapy for traumatic wounds / 中华创伤杂志

Objective:To study the clinical efficacy of vacuum sealing drainage (VSD) plus topical oxygen therapy for traumatic wounds.Methods:A retrospective case-control study was conducted to analyze the clinical data of 60 patients with traumatic wounds admitted to Daping Hospital of Army Medical University from July 2016 to June 2019, including 34 males and 26 females, aged 22-72 years[(42.2±12.8)years]. There were 48 patients with wound sites in lower extremities, 9 in upper extremities, 3 in back. The area of the wounds was 30-156 cm 2[(76.9±25.1)cm 2]. A total of 20 patients were treated with regular dressing (Group A), 20 patients were treated with VSD plus irrigation of saline (Group B), and 20 patients were treated with vacuum sealing drainage plus irrigation of saline loaded with oxygen (Group C). Bacteria clearance rate, granulation tissue coverage rate and partial pressure of oxygen of the exudate in wounds were compared among the three groups. Foam dry rate and blockage rate of drainage tube were compared between Group B and Group C. Wound healing time, dressing change time and hospitalization day were compared among the three groups. Results:Bacterial clearance rate of wounds in Group B [(78.3±7.0)%] and Group C [(85.3±9.7)%] was higher than that in Group A [(58.5±11.1)%] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). Granulation tissue coverage rate of wounds in Group B [(71.5±9.9)%] and Group C [(86.0±9.2)%] was higher than that in Group A [(49.1±14.7)%] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). Partial pressure of oxygen of the exudate in wounds in Group B [(49.5±10.1)%] and Group C [(80.9±12.1)%] was higher than that in Group A[(49.4±11.2) %] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). The foam dry rate [9.5 (5.0, 13.8)%] and drainage tube blockage rate [0.6 (0, 1.7)%] in Group C showed no significant difference with that [9.0 (5.0, 10.0)%, 0.6 (0, 1.2)%] in Group B ( P>0.05). Wounds healing time in Groups A, B, C were (36.5±4.8)days, (25.9±3.9)days, (25.5±4.2)days, respectively; dressing change times in Groups A, B, C were 23.0 (20.3, 27.8)times, 8.0 (6.0, 9.0)times, 7.5 (5.3, 9.0)times, respectively; hospitalization day in Groups A, B, C were 23.5 (19.0, 27.8)d, 17.0 (15.3, 19.0)d, 17.0 (16.0, 18.8)d, respectively. These outcomes in Group B and Group C showed significant differences compared to Group A ( P<0.05), while there were no significant differences between Group B and Group C ( P>0.05). Conclusions:VSD plus topical oxygen therapy can facilitate wound healing and reduce dressing change frequency for traumatic wounds compared to traditional methods. The technique can also improve bacterial clearance rate and granulation tissue coverage rate of wounds compared to VSD plus irrigation of saline, but the difference of wounds healing time is similar.

Correlation between tobacco use and health literacy among adults in Putuo District, Shanghai City / 上海预防医学

Objective To explore the relationship between adult tobacco use and health literacy, and to provide evidence for tobacco control intervention and health promotion. Methods By combining PPS method and KISH table method, the 2018 National Residents′ Health Literacy Monitoring Questionnaire was used to investigate the health literacy level and tobacco use, and the correlation between current smoking behavior and health literacy among residents aged 15-69 was analyzed by logistic regression. Results A total of 3 200 people were surveyed, and 3 185 valid questionnaires were recovered, with an effective rate of 99.53%.The current smoking rate of people with scientific health literacy, infectious disease prevention literacy, safety and first aid literacy, basic medical literacy and health information literacy was lower than those without (P < 0.05).The results of multivariate logistic regression analysis showed that the current smoking rate of males was higher than that of females (OR=25.900, 95%CI:17.018-39.416).The current smoking rates in groups aged 25-69 were higher than those in groups aged 15-24 (OR=4.956-9.178, 95%CI:1.179-37.940).The current smoking rates of workers, employees of other enterprises and other professionals were higher than those of employees of government institutions (OR=1.488-1.913, 95%CI:1.082-3.055).People without basic medical literacy had a higher smoking rate than those with basic medical and health literacy (OR=1.366, 95%CI:1.057-1.765). Conclusion From now on, we should carry out health literacy promotion and tobacco control propaganda for key groups, improve the level of basic medical and health literacy and reduce the smoking rate.

Analysis on the hierarchical medical system of regional longitudinal medical consortium based on system dynamics / 中国卫生政策研究

Objective: To analyze the change in community first diagnosis and two-way referral rate under the condition of the regional longitudinal medical consortium implementation in the country at large. According to the simulation results,some suggestions for hierarchical medical system were put forward. Methods : The community first diagnosis and two-way referral rates were determined using the literature meta-analysis, and were simulated under different conditions by means of the system dynamics. Results :The analysis results confirmed that simply increasing the financial subsidies can increase the community first diagnosis rate within a range from 0.08％ to 0. 17％. For in case increases are made by the government in technical financial input to enhance the technical level of the community health service centers and in compensatory financial input to reduce the higher hospitals dependence on the light disease, results showed that the lower conversion rate increased within the range of 0.33％～0.45％ in terms of the two-way referral rating. On the contrary, when technical financial input is increased to improve the technical level of community health service centers, the rate of change was in the range of 7.52％ '- 12.61％ - Conclusions : Firstly, the diversified strategy should be used to promote the achievement of graded diagnosis and treatment. Secondly, the Health Commission plays a key role in the promotion of themedical consortiumconstruction. Thirdly, medical insurance reimbursement differential strategy should be implemented and the supply-side reform should be strengthened. At last,attention should be paid to the rational development of existing referrals, especially the upper and lower ones.

Time series analysis of per diem expense of inpatients with chronic kidney disease in a tertiary referral hospital in Shanghai / 第二军医大学学报

Objective To study the tendency of per diem expense and drug cost ratio of inpatients with chronic kidney disease (CKD) and the top three diseases (chronic renal failure, nephrotic syndrome, and primary glomerulonephritis) in a tertiary referral hospital in Shanghai from 2011 to 2016, so as to predict the per diem expense and drug cost ratio of inpatients in 2017. Methods We analyzed the per diem expense, drug cost ratio and other general situation of inpatients with CKD, and conducted the modeling research by the expert modeler in SPSS 23.0 software time series analysis module. Firstly, the per diem expense and drug cost ratio of inpatients with CKD from Jan. 2011 to Dec. 2015 were used to build model, and then the per diem expense and drug cost ratio of the inpatients in 2016 predicted by the model were compared with the real data of the inpatients in 2016 and the values of the model were evaluated. Secondly, the per diem expense and drug cost ratio of inpatients with CKD in 2017 were predicted. Finally, according to the same principle, the per diem expense and drug cost ratio of inpatients with chronic renal failure, nephrotic syndrome and primary glomerulonephritis in 2017 were predicted. Results The per diem expense, per capita hospitalization expense and per capita drug expense of inpatients with CKD increased annually from 2011 to 2016, and the expenses were (1 506.89±1 003.34) yuan, 8 252.51 yuan and 2 009.88 yuan in 2016, respectively, with the growth rates being 62.38%, 41.62% and 14.44%, respectively. The drug cost ratio of the inpatients decreased annually, and the ratio reached 32.33% in 2016. The time series models established by the per diem expense and drug cost ratio of inpatients with CKD were Winters additive model and simple seasonal model, respectively. According to the time series model, the predicted per diem expense and drug cost ratio in 2016 were consistent with the real values in 2016. The per diem expense and drug cost ratio of inpatients with CKD in 2017 predicted by the time series model were about 1 600 yuan and 30%, respectively. The predicted per diem expenses of inpatients with chronic renal failure, nephrotic syndrome and primary glomerulonephritis in 2017 were about 1 700 yuan, 1 800 yuan and 1 600 yuan, respectively, and the predicted drug cost ratios were about 30%, 35% and 10%, respectively. Conclusion The hospital income structure is constantly optimized, and a real-time disease cost monitoring information platform should be established. The research based on the trend of single disease expense needs to be further studied.

Investigation of inpatients with chronic kidney disease in a tertiary referral hospital in shanghai from 2011 to 2016 / 第二军医大学学报

Objective To analyze the demographic information and related costs of inpatients with chronic kidney disease (CKD) in a tertiary referral hospital in Shanghai from 2011 to 2016, so as to provide reference for further understanding and improving the current situation of medical treatment of patients with CKD in Shanghai. Methods We retrospectively reviewed the clinical data (age, gender, hospital stay, disease diagnosis, hospitalization expenses and so on) of inpatients with CKD in a tertiary referral hospital in Shanghai from 2011 to 2016. The general characteristics and disease diagnosis of the inpatients with CKD were statistically analyzed by calculating the proportion of each index using a simple statistical description method. The treatment, hospitalization expenses of the inpatients with CKD were compared between different groups by variance analysis and non-parametric test. Results The percent of inpatients from Jiangsu, Zhejiang, Anhui and Jiangxi provinces around Shanghai was 49.97% (10 033/20 079), surpassing that of inpatients from Shanghai (38.78%, 7 787/20 079). The proportion of inpatients with chronic renal failure was the highest (51.98%, 10 438/20 079), and more young people tended to suffer from the disease. The per capita hospitalization expense was increased annually, and the median hospitalization expense was 8 252.51 yuan in 2016. There were significant differences in per capita hospitalization expenses between the different year groups (P0.001). Conclusion Active and effective measures should be taken to deal with the problem of large numbers of nonlocal patients seeking medical services in Shanghai. It is necessary to popularize the knowledge about CKD in young people, and reduce the social and personal losses due to the illness. The economic burden caused by CKD needs to be further studied.

Investigation on the Demands and Evaluation of Medical Personnel and Patients towards Clinical Pharmacists in 56 Third Grade Class A Hospitals of 17 Provinces(Regions,Cities) / 中国药房

OBJECTIVE:To provide reference for the clinical pharmacists to determine their work orientation,and improve their work mode and pharmaceutical care level. METHODS:The questionnaire survey was conducted among doctors,nurses, patients and pharmacists from 65 third grade class A hospitals of 18 provinces(regions,cities)in China. The collected data were analyzed statistically and suggestions were presented. RESULTS:Totally 3 840 questionnaires were sent out,3 045 were effectively received with a recovery of 79.30%[involving 56 third grade class A hospitals of 17 provinces(regions,cities)]. Of 3 045 valid questionnaires,1 001 questionnaires were filled out by the doctors and nurses,1 013 questionnaires were filled by the pharmacists and 1 031 questionnaires were filled out by the patients. 88.45% of the survey doctors and nurses thought that clinical pharmacists were needed in their wards. The major clinical pharmaceutical care they needed were the participation of clinical pharmacists in the clinical ward round,patients management,difficult case discussions,consultation(77.32%),etc. 64.54% of the survey doctors and nurses thought that clinical pharmacists could participate the clinical work and solve some simple medicine-related problems, and 27.17% of the survey doctors and nurses thought that clinical pharmacists could resolve clinical medicine-related problems. 14.59% of the survey doctors and nurses believed that clinical pharmacists lacked clinical thinking and could not communicate with medical staff. The most common problems the survey medical staff met were as follows:ADR (78.02%),usage and dosage(72.83%),contraindications(72.63%),drug indication(63.14%)and solvent selection (61.74%),etc. As regards the ratio of working time which clinical pharmacists spent on their clinical work,over 50%(35.55%)and 30%(23.46%)were most chosen by the survey pharmacists,while 13.19% of the survey pharmacists thought clinical pharmacists almost did not participate in clinical work. The survey pharmacists thought that there were some deficiencies in the knowledge structure of clinical pharmacists, such as clinical medical science and therapeutics(92.50%), communication skills(47.19%),professional knowledge of pharmacy(46.10%),etc. 87.90% of the survey patients were willing to accept the medication guidance provided by clinical pharmacists. The services they required were as follows:medication guidance(79.92%),observation and discovery of medication problem(71.00%),etc. CONCLUSIONS:Medical staff and patients have demands in many ways associated with clinical work and rational drug use provided by clinical pharmacists,while the clinical pharmacists have yet not reached the demands of medical staff and patients in regard to their evaluation. It is suggested that the clinical pharmacists should ascertain their work orientation,improve their work mode,participate the clinical work in full-time, complete their knowledge structure and ascent their pharmaceutical service level.

Selection of policy tools for constructing tiered medical care system: A Quantitative analysis based on provincial government policy text / 中国卫生政策研究

Objective:To compare and analyze the choice and application of policy tools in the construction of hierarchical medical system in different provinces of china, and to provide advice for improving the effectiveness of the hierarchical medical policy implementation. Methods:Retrieve the policy documents of provincial governments on hierarchical medical policy through internet search;sort names and categories of policy tools based on the classifica-tion of policy tools by Rothwell&Zegveld after consulting the expert,and analyze the use of policy tools by calculating the frequency of different policy tools. Results:This study has summed up 15 types of policy tools in 3 categories in-cluding demand,supply,and environment of provincial hierarchical medical policy. Supply policy tools accounted for 32.92%,demand policy tools accounted for 20.58%, and environmental policy tools accounted for 46.50%. The most widely used policy tool is the regulatory control, and the least used policy tool is the disease catalog. Conclu-sions:Among the choice of policy tools,the category of environmental policy tools are the most widely used,and de-mand policy tools are applied the least. The use of three types of policy tools in the eastern region are balanced,the demand policy tools in Central China are relatively few, and the environmental policy tools are widely used in the western region,while the demand oriented policy tools are scarce.

Case analysis of linezolid in treatment of hospital-acquired MRSA pneumonia after ineffective glycopeptide antibiotics treatment / 重庆医学

Objective To analyze the case of inezolid in effectively treating hospital-acquired methicillin-resistant staphylo-coccus aureus (MRSA) pneumonia after ineffective glycopeptide antibiotics treatment in order to provide opinions for the clinical use .Methods The antibacterial drugs analysis was performed on 1 case of hospital-acquired MRSA pneumonia after acute subdural hematoma removal operation in this hospital ,and the curative effects and economic indicators of glycopeptide antibacterial drugs and inezolid were conducted the evidence-based evaluation .Results Using glycopeptide antibacterial drugs in this patient had poor cura-tive effect ,and then changing to inezolid anti-infection treatment obtained the success .This patient used vancomycin 2 g ,generic teicoplanin 400 mg and inezolid 1200 mg per day ;the average daily costs were 497 ,341 ,788 Yuan respectively .Conclusion Lin-ezolid can be selected for treating hospital-acquired MRSA pneumonia patient after ineffective glycopeptide antibacterial drugs treat-ment .

Effects of butylphthalide on cognitive ability and mitochondrial function in dementia model rats / 西安交通大学学报(医学版)

Objective To explore the protective effects of butylphthalide against Aβ25-35 induced dementia-like pathological rat model and reveal the mechanism.Methods Rats were divided into five groups:control group, model group and NBP groups (10,30,and 100 mg/kg).In model group and butylphthalide groups,Aβ25-35 was injected into the lateral ventricle,while the rats in intervention group were administered with butylphthalide (gastric infusion dose of 2.5 mL/kg).Learning and memory abilities of the rats were observed with water maze test. Mitochondrial function in brain tissue was observed by ATP assay,and the mitochondrial related enzyme activities were detected by the kit.Results Water maze test showed that learning and memory abilities of model group were poorer than those of control group.They were significantly improved in NBP 10 mg/kg group and 30 mg/kg group (P <0.05),but did not change significantly in 100 mg/kg group.Compared with control group,model group had significantly decreased ATP level (P < 0.05 ); cytochrome c oxidase, pyruvate dehydrogenase complex and ketoglutarate dehydrogenase activities were also significantly decreased (P < 0.05 ).Compared with model group, butylphthalide group had significantly improved activities of mitochondrial enzymes that improved mitochondrial function.Conclusion Butylphthalide can improve learning and memory abilities of rats with Aβ25-35 -induced dementia by improving mitochondrial function.

Effects of butylphthalide on cognitive ability and mitochondrial function in dementia model rats / 西安交通大学学报(医学版)

Objective To explore the protective effects of butylphthalide against Aβ25-35 induced dementia-like pathological rat model and reveal the mechanism.Methods Rats were divided into five groups:control group, model group and NBP groups (10,30,and 100 mg/kg).In model group and butylphthalide groups,Aβ25-35 was injected into the lateral ventricle,while the rats in intervention group were administered with butylphthalide (gastric infusion dose of 2.5 mL/kg).Learning and memory abilities of the rats were observed with water maze test. Mitochondrial function in brain tissue was observed by ATP assay,and the mitochondrial related enzyme activities were detected by the kit.Results Water maze test showed that learning and memory abilities of model group were poorer than those of control group.They were significantly improved in NBP 10 mg/kg group and 30 mg/kg group (P <0.05),but did not change significantly in 100 mg/kg group.Compared with control group,model group had significantly decreased ATP level (P < 0.05 ); cytochrome c oxidase, pyruvate dehydrogenase complex and ketoglutarate dehydrogenase activities were also significantly decreased (P < 0.05 ).Compared with model group, butylphthalide group had significantly improved activities of mitochondrial enzymes that improved mitochondrial function.Conclusion Butylphthalide can improve learning and memory abilities of rats with Aβ25-35 -induced dementia by improving mitochondrial function.

Effects of bencycloquidium bromide on the expression of MUC5 AC induced by lipopolysaccharide in cultured human nasal epithelial cells / 中国药理学通报

Aim Toinvestigatetheeffectofbencyclo-quidium bromide(BCQB)on mucus MUC5AC expres-sion induced by lipopolysaccharide in cultured human nasalepithelialcells(HNECs).Methods Primary culture of human nasal epithelial cells (HNECs)was randomly divided into control group (C,with no treat-ment),LPS group (LPS,with LPS 1 mg · L-1 added in),BCQB low dose group(BCQBL,with LPS 1 mg· L-1 and BCQB 10 -8 mol·L-1 added in),BCQB mid-dle dose group(BCQBM,with LPS 1 mg·L-1 and BC-QB 10 -7 mol·L-1 added in),BCQB high dose group (BCQBH,with LPS 1 mg·L-1 and BCQB 10 -6 mol· L-1 added in)and ipratropium bromide group(IB,with LPS 1 mg·L-1 and IB 10 -6 mol·L-1 added in).Af-ter incubation at 37 ℃with 5% CO2 for 24 h,the ex-pression of MUC5 AC mRNA was detected with Real-time PCR and the expression of MUC5 AC protein in HNECs was detected with Western blot,while the ex-pression of MUC5 AC protein in supernatant was detec-tedwithELISAineachgroup.Results Ascompared with control group,the expression of MUC5 AC mRNA and protein increased significantly in LPS group (each P0. 05 ). Conclusion Bencycloquidiumbromidecansuppress MUC5 AC expression induced by LPS in cultured hu-man nasal epithelial cells,indicating that BCQB may be a new drug for nasal mucous hypersecretion diseases.

Efficacy and Safety of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis:A Systematic Review / 中国药房

OBJECTIVE:To systematically review the efficacy and safety of pirfenidone in the treatment of idiopathic pulmo-nary fibrosis (IPF),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library, PubMed,EMBase,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials (RCT) about the efficacy and safety of pirfenidone (test group) versus placebo (control group) in the treatment of IPF were collected,and Meta-analysis was performed by using Rev Man 5.1.7 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 4 RCTs were enrolled,involving 1 153 patients. Results of Meta-analysis showed the decrease value of lung capacity [WMD=0.39,95%CI(0.16,0.61), P<0.001] and decrease value of the percentage of forced vital capacity to expected value [RR=0.68, 95%CI(0.53,0.87),P=0.002] in test group were lower than control group,there was significant difference between 2 groups;there was no significant difference in the lowest oxygen saturation [WMD=0.53,95%CI(-0.78,1.84),P=0.43] between 2 groups,however,the results of subgroup analysis showed the remission degree of 1 200 mg/d PFD for the decrease of lowest oxy-gen saturation was superior to placebo group,there was significant difference between 2 groups [WMD=1.72,95%CI(1.33,2.10), P<0.001],but therewas no significant difference between the remission degree of 1800 mg/d and placebo;and there was no signifi-cant difference in the incidence of adverse reactions between 2 groups [RR=1.70,95%CI(0.46,6.31),P=0.43],but the incidence of photosensitivity veactions in test group was significantly higher than that of control group,there was significant difference [RR=9.35,95%CI(4.23,20.67),P<0.001]. CONCLUSIONS:The efficacy of pirfenidone in the treatment of IPF is good,but the inci-dence of photosensitivity reactions should be noticed.

Percutaneous nephrolithotomy through the upper pole calix access for complicated renal calculi: report of 581 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To discuss the optimal approach of percutaneous nephrolithotomy (PCNL) for treatment of complicated renal calculi.</p><p><b>METHODS</b>A total of 581 patients with complicated renal calculus were treated by PCNL through the upper pole calix access. Of the 581 patients, 55 had multiple upper pole calculi, 136 had staghorn stones, 145 had partial staghorn stones, and 245 had multiple renal calculi.</p><p><b>RESULTS</b>PCNL through the upper pole calix access was completed successfully in all the cases. Of these patients, 90.3% (525/581) were stone-free after a single access, with a total stone-free rate of 94.6% (550/581). Thirty-five patients needed two accesses, 10 needed 3 accesses, 2 required 4 accesses, and 1 patients had 5 accesses. The operative time ranged from 30 to 150 min (mean 45 min). The successful rate of puncture was 100% without occurrence of severe injury of the pleura, intestine, peritoneum or other adjacent organs.</p><p><b>CONCLUSIONS</b>Percutaneous nephrolithotomy through the upper pole calix access allows greater stone clearance rate due to its easy access into the intrarenal collecting system and can be an ideal approach for PCNL for complicated renal calculi.</p>

Effect of acupuncture on blood oxygen saturation in patients of obstructive sleep apnea-hypopnea syndrome / 中国针灸

<p><b>OBJECTIVE</b>To investigate the effect of acupuncture on blood oxygen saturation in the patient of obstructive sleep apnea-hypopnea syndrome (OSAHS) in sleeping and to evaluate the therapeutic effect of acupuncture on this disease.</p><p><b>METHODS</b>Thirty cases with OSAHS were treated with acupuncture at Shanglianquan (Extra), Fengfu (GV 16), Yamen (GV 15), Fengchi (GB 20), etc. 3-5 sessions each week. After treatment of 30 sessions, apneahypopnea index (AHI), mean blood oxygen saturation (MSaO2), the lowest blood oxygen saturation (LSaO2), oxygen desaturation > or = 4% index (ODI4), the mean blood oxygen saturation of oxygen desaturation when SaO2 < 90%, the longest time of oxygen saturation > or = 4% were observed before and after treatment.</p><p><b>RESULTS</b>The effective rate of acupuncture was 23.3% for OSAHS. After acupuncture, AHI and ODI4 significantly reduced (P < 0.01); LSaO2 significantly increased (P < 0.01); MSaO2 and the mean blood oxygen saturation of oxygen desaturation when SaO2 < 90% significantly enhanced (P < 0.05); the longest time of oxygen saturation > or = 4% did not significantly change.</p><p><b>CONCLUSION</b>The acupuncture treatment has intervenient effect on OSAHS and alleviates anoxia, so acupuncture is one of therapies improving anoxia in patients of OSAHS.</p>

Reference values of differences between TW3-C RUS and TW3-C Carpal bone ages of children from five cities of China / 中华儿科杂志

<p><b>OBJECTIVE</b>The determination of skeletal maturity has an important role in pediatric clinical practice, especially in relation to endocrinological problems and growth disorders, and it is frequently useful in diagnosis and monitoring treatment. It has been suggested that the difference between radius, ulna and short bonse (RUS) and carpal may be of differential diagnostic significance. However, no data on comparison among bone ages of Chinese children are available. The differences between TW3-Chinese RUS (TW3-C RUS) and TW3-Chinese Carpal (TW3-C Carpal) bone age of Chinese children were observed in this study to provide references for skeletal development estimation.</p><p><b>METHODS</b>Totally 9408 Han healthy children (5066 boys, 4302 girls) aged 1.5 - 13.5 years from 5 cities of China were enrolled in this study. The bone ages of the children were estimated by TW3-C RUS and TW3-C Carpal. The Z score curves of the differences between them were fitted by BCPE distribution and the goodness-of-fit of Box-Cox power exponential distribution (BCPE) models were assessed by Q-test and percents of cases of sample below the fitted percentile curves.</p><p><b>RESULTS</b>The means of the differences between TW3-C RUS and TW3-C Carpal were -0.19 - 0.17 over the age 2.0 - 13.5 years in boys and -0.12 - 0.13 from age 1.5 - 11.5 years in girls. The standard deviations were respectively 0.47 - 1.01 years for boys and 0.49 - 0.82 years for girls. The degrees of freedom, with respect to the parameter curves from BCPE distribution, were selected and the percentile curves were fitted by BCPE. The differences between percents of cases below the fitted percentile curves and expected values were all under 0.66%, exception of difference for 90th percentile in girls.</p><p><b>CONCLUSIONS</b>The differences between TW3-C RUS and TW3-C Carpal varied with age, the standard deviations increased gradually before 4.5 years of age in boys and 4 years of age in girls, and afterwards the variations decreased steadily until the TW3-C Carpal has reached full maturity. However, there was sex diversity in the extent of the variations. The differences between TW3-C RUS and TW3-C Carpal for boys were evidently greater than that for girls. The sex difference decreased progressively after 10 years. The proposed Z scores curves charts should provide reference for clinical practice.</p>

Influence of Xinqin tablets on guinea-pig nasal hypersensitivity / 中国中药杂志

<p><b>OBJECTIVE</b>To study the influence of Xinqin tablets on guinea-pig nasal hypersensitivity.</p><p><b>METHOD</b>2,4-Toluene Diisocyanate (TDI) was selected as antigen and used in nose to establish guinea-pig allergic rhinitis. The effects of Xinqin tablets on symptoms of nasal hypersensitivity in guinea-pigs, histamine content of nasal mucosa and activity of nitric oxide synthase (NOS) were examined.</p><p><b>RESULT</b>Xinqin tablets could significantly relieve the pathological symptoms of nasal hypersensitivity in guinea-pig, reduce histamine content of nasal mucosa and inhibit the activity of nitric oxide synthase.</p><p><b>CONCLUSION</b>Xinqin tablets have significant effect on nasal hypersensitivity, and prevent the occurrence of allergic rhinitis.</p>