Differences in Contents and Formation Methods of Clinical Questions in Chinese and Korean Clinical Practice Guidelines of Acupuncture-Moxibustion: Scoping Review / 中国结合医学杂志

OBJECTIVE@#To analyze the differences in the needs of users and the value orientation of clinical practice guidelines (CPGs) by comparing the contents and formation methods of clinical questions in Chinese and Korean CPGs of acupuncture-moxibustion (Acup-Mox).@*METHODS@#The full text of CPGs was systematically searched from the official websites of Chinese and Korean traditional medicine societies and Acup-Mox associations, with the topic "Acup-Mox for treating diseases" and the retrieval time up to September 28, 2022. Two researchers screened the CPGs independently, and extracted the guidelines' topics, content, quantity and formation methods of clinical questions. The quantitative data were collected by counting the frequency, and the qualitative data were classified and described by thematic analysis.@*RESULTS@#A total of 29 guidelines were included in this study, including 20 Chinese guidelines (305 questions) and 9 Korean guidelines (223 questions). The differences lie in the aspects of content and diversity, and formation method. As for content and diversity, Chinese guidelines focused mainly on the questions related to treatment such as the operation of specific intervention (86, 28.2%), efficacy of intervention (78, 25.6%), and also involving questions in diagnosis, prevention, and prognosis. While the clinical questions in Korean guidelines were concentrated to efficacy of intervention (218, 97.8%). As for formation method, in Chinese guidelines, questions were usually collected directly from clinicians, and then determined and optimized by experts. In Korean guidelines, frequently used clinical Acup-Mox interventions would be screened first. Then the expert group would set up corresponding intervention control measures so as to form clinical questions related to treatment efficacy.@*CONCLUSIONS@#The differences reflect the different needs of clinical practitioners, and the different aims or concepts in developing Acup-Mox guidelines between China and South Korea. Chinese guidelines emphasized promoting operation protocols and techniques of Acup-Mox for practical use, while Korean guidelines emphasized promoting the frequently used clinical intervention therapies. It is speculated that the guidelines from these two countries would play different roles in guiding clinical operation and supporting medical decision. In terms of formation methods of clinical questions, it is suggested to attach importance to optimizing process in formatting clinical questions to improve the clinical applicability of CPGs of Acup-Mox.

Study on the dilemma and optimization of applying the rule of inversion of proof in the diagnosis of occupational diseases——Comment on article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases / 中国职业医学

In the process of occupational disease diagnosis and verification, the rule of inversion of proof is implemented. The purpose of proof is to solve the causal relationship between occupational hazardous factors and occupational diseases in the workplace, and its essence is the responsibility for consequences. However, in the practice of diagnosis and verification of occupational diseases, there are many difficulties in the application of the rule of inversion of burden of proof, which is dare not apply, difficult to apply, and wrong application might occur. Satisfying probability is the premise for the application of the rule of inversion of burden of proof. The relevant judgment of evidence is the basic way to apply the rule. Optimize the article 28 of Administrative Measures for Diagnosis and Verification of Occupational Diseases, delete the precondition “urged by health authorities”, that is an important guarantee for the accurate application of the rule. To clarify the nature of the burden of proof, correctly apply and optimize the rules of proof in the practice of diagnosis and verification occupational diseases, further improve the legislation, and promote the accurate application of the relevant legal system are conducive to protecting the rights and interests of workers in occupational health and implementing the principal responsibility of employers for occupational disease prevention and control.

Selection of DNA aptamers to cervical intraepithelial neoplasia by SELEX / 生物工程学报

An in vitro synthesized random ssDNA library was subjected to 12 rounds of selection against anti-screening cells and sieving cells by SELEX. Normal and inflammatory cervical exfoliation cells were selected as anti-screening cells, and the cervical exfoliation cells of low-grade squamous intraepithelial lesion (CIN1), high-grade squamous intraepithelial lesion (CIN2, CIN3) and cervical carcinoma were selected as sieving cells during the screening process. Then, the highly specific aptamer CIN-Ap4 was established by the analysis of the specificity, affinity and cell immunofluorescence, which can be used as biomarker for Cervical Intraepithelial Neoplasia. Prime Premier 5.0 was applied to design a random ssDNA library. According to the fixed sequence at both ends of the library, a pair of primers were designed and synthesized. At the same time, the optimal annealing temperature, cycle times and primer concentration ratio of PCR procedure were selected. The results under the optimal condition are shown as follows. In the 50 μL reaction system, the optimum reaction conditions of symmetry PCR are as follows: annealing temperature is 49.5 ℃, number of cycles is 15. The optimal reaction conditions of indirect asymmetric PCR are as follows: the primer concentration ratio is 80:1, and the number of cycles is 35. The experiment proves that the oligonucleotide library is constructed successfully, and the highly specific dsDNA and ssDNA can be obtained under optimal PCR conditions with good repeatability, which establishes the foundation for the further exploration and experimentation.

A preliminary study of template library-based auto-planning of volume modulated arc therapy / 中华放射肿瘤学杂志

Objective To explore the feasibility of the volume modulated arc therapy ( VMAT) auto-planning based on template library ( TL). Methods VMAT plans of 68 patients diagnosed with postoperative rectal cancer in Eclipse system were retrospectively selected. The prescription dose was 50 Gy/25F. In 19 patients, the feature values of target and organs at risk were extracted as the vectors. The final optimized restricted conditions were saved as the TL. Then, the plans of 15 rectal cancer patients (10 cases from TL and 5 outside TL) were automatically optimized. According to the multi-dimensional vector similarity principle, the similarity parameter αwas defined. The designed program automatically selected the optimal-object template in an in-house software developed with Matlab. The dosimetric parameters of the auto-optimized plans with the optimal-object template (ATP) and the clinical plan (CP) were compared by the paired t-test. The changes in the dosimetric parameters and similarity parameter α were statistically compared by Pearson′s correlation analysis. The linear fitting of the dosimetric parameters with α was used by least squares method to explore the tendency of the ATP dosimetric parameters relative to CP. Results The dosimetric parameters of ATP for 13 cases were slightly worse than those of CP. The conformal index (P=0. 004), heterogeneous index (P= 0. 015),V40(P= 0. 003) and mean dose (P= 0. 022) of the intestine significantly differed. The α values of these 13 cases were 2. 67,2. 60,2. 60,2. 49,2. 67,2. 74,2. 72,2. 48, 2. 53,2. 86,2. 68,2. 56 and 2. 63. The α value was significantly correlated with the V40 or mean dose of the bladder (r= 0. 649 and 0. 603,P= 0. 016 and 0. 029).Along with the increase of α value ,V40 and mean dose of the intestine for ATP were gradually deteriorated than those of CP . The remaining dosimetric para-meters of ATP were close to or superior to those of CP. Conclusions The results of ATP are slightly worse than those of CP, whereas can satisfy the clinical requirements. The TL, the quality of TL and ATP remain to be further optimized.

Optimization of therapy on ICU post-cardiac arrest syndrome cerebral resuscitation ;clinical study / 中国医学装备

Objective: To investigate the optimal therapy for ICU post-cardiac arrest syndrome (PCAS) clinical efficacy in patients with cerebral resuscitation. Methods: In our hospital intensive care unit (ICU) treatment of cardiac arrest and the successful recovery of the 92 patients ,using randomly divided into control group and observation group of 46 cases, in which the control group taking conventional treatment hospital ICU, observation group hospital ICU optimize treatment , two groups of patients in the ICU treatment period nerve function, complications and mortality rates were analyzed. Results:The patients in the ICU and duration of mechanical ventilation was no significant difference, but a good neurological outcomes observed group of patients , 45.7%, significantly better than the control group, 21.7% , and the mortality rate was 45.7%, 73.9%, significantly lower than the control group , the difference was statistically significant (x2=3.84, P<0.05);complications compared in the two groups showed no significant difference. Conclusion: ICU optimize treatment can significantly improve cardiac arrest syndrome nerve function , and can effectively reduce mortality , worthy of further application.

Study on compatibility of vidarabine monophosphate for injection and aciclovir injection / 中国生化药物杂志

Objective To study optimal compatibility scheme of vidarabine monophosphate for injection combined with aciclovir injection. Methods L18(35) of orthogonal design was used with five factors: temperature, illumination,storage time,solvent and solvent dosage;the insoluble particles were observed by GWJ-4 type particle analyzer.The content of vidarabine monophosphate and aciclovir was detected by HPLC.Optimization of the best scheme of vidarabine monophosphate for Injection combined with aciclovir injection was studied.Results The regression equation of vidarabine monophosphate and aciclovir were A=3.78 ×104C+2.32, r=0.9997(n=5)and A=7.11 ×105C-4.65, r=0.9995(n=5),The results showed that the relationship between the range of 200-900μg/mL(vidarabine monophosphate) and the range of 1000-4500μg/mL(aciclovir) was good.The optimal compatibility conditions are the follows:temperature of 25,as far as possible away from light;Vidarabine monophosphate for injection 1 (0.1 g/branch) and 1 acyclovir injection (10 mL:0.5 g) mixed with 100 mL 0.9% sodium chloride injection,and dropping out within 4 h after compatibility. Conclusion The optimal compatibility scheme has good repeatability,injection solution stability is good.It prouides scientific reference for the safty of clinical rational drug use.

Compatible stability of Shuxuening injection and meglumine adenosine cyclophosphate injection / 中国生化药物杂志

Objective To study the compatibility stability of Shuxuening injection and meglumine adenosine cyclophosphate injection . Methods The compatibility program of Shuxuening injection and meglumine adenosine cyclophosphate injection was optimized by orthogonal experimental design, with the main components total flavone of Ginkgo biloba ( quercetin, kaempferide and isorhamnetin as control substance) and Ginkgo lactone ( ginkgolide A, B and C as control substance) of Shuxuening injection, the principal components adenosine cyclophosphate ( denosine cyclophosphate as control substance) of meglumine adenosine cyclophosphate injection as the main index to draw calibration curve, select temperature (A), illumination (B),storage time (C) and solvent (D) as factor, the change of insoluble particles and pH in solution was studied also.Results The optimal compatibility conditions of orthogonal experimental design was A2B1C1D1(25℃, lucifugal, storage time of 1 h,5% glucose solution), ANOVA results showed that temperature (A), illumination (B) and storage time (C) have significant effects on quercetin and kaempferide contents in Shuxuening injection (P<0.05), however, solvent (D) has no significant effect on them.The temperature (A), illumination (B),storage time (C) and solvent (D) have significant effects on the other five substances (P<0.05).At 0, 1, 4, 6 h, the appearance and pH value of compatible solution (A2B1C1D1) were not significantly changed and the number of insoluble particles in accordance with the relevant provisions of the Chinese Pharmacopoeia with storage time increasing.Conclusion The compatible stability of Shuxuening injection and meglumine adenosine cyclophosphate injection is good under certain conditions, and could use compatibility in clinical therapy.

Optimization in the construction of the hospital PACS / 中国医学装备

Objective:To Integrated PACS and hospital information systems (HIS), and improve the efficiency of PACS, and improve the user experience. Methods:Base on deeply analysis of existing problems in system application, using process optimization, software optimization, and hardware upgrades manner optimize PACS. Results: PACS and HIS realized Integrated, improving the overall performance of the PACS. Enhance the user experience and expand the application scope of PACS. Conclusion: Deeply analysis of existing problems should be done before optimizing the system. Process optimization, software environment optimization should be considered as the most important and upgrading and replacement of the hardware as the secondary.

An application of template in intensity modulated radiotherapy planning / 中华放射肿瘤学杂志

Objeetive To study the application of template in intensity modulated radiotherapy (IMRT)planning.Methods With Philips Pinnacle3(R) version 7.6c treatment planning system(TPS) platform.a template for left breast cancer's IMRT planning was customized by using the function of scripting.Ten patients received IMRT alone after breast-conserving surgery were selected,two IMRT plans were designed for each patient:individual plan and the plan based on the template.Dose parameters of target,including conformal index(CI)and homogeneity index(HI),dose-volume histogram parameters,including V30,V20 of lung and cardiac,and the planning time were compared respectively.Results Of the two IMRT plans based on the template method and individual method.The average time of design an IMRT plan were 7±0.82 min and 36.5±6.84 min(t=13.55,P=0.000),the PTV average CI were 0.851± 0.015 and 0.845±0.032(t=0.59,P=0.560),the PTV average HI were(13.2±1.3)%and(14.4±1.6)%(t=1.804,P=0.08),the lung average V30 were(8.80±0.53)%and(8.31±0.74)%(t= cardiac average V30 were(9.89±1.14)%and(9.66±1.43)%(t=0.41,P=0.688).Conclusion For the tumor with the same location and stage,the application of template can simplify planning process and reduce working time,which was worthy of expansion.

Processing technique of Phytolaccae Radix stir-baked with vinegar / 中草药

Objective: To optimize the best processing technique of Phytolaccae Radix stir-baked with vinegar. Methods L9(34) orthogonal test was used with three factors: baked temperature, time, and vinegar amount. The content of esculentoside A was determined by RP-HPLC, and the mucosa irritation test of mice was detected. The processing technology was optimized by comprehensive evaluation. Results: The optimized processing technology was satisfied with some conditions as the following: stir-baked with 30% vinegar for 30 min at the temperature of 120 °C. Phytolaccae Radix was moistened with vinegar to be exhausted. Conclusion: The optimized processing technology of Phytolaccae Radix is stable and feasible with reliable repetition.

Application of correlation statistical analysis model in IMRT planning optimization / 中华放射肿瘤学杂志

Objective To study the application of correlation statistical analysis model in IMRT planning optimization. Methods A correlation statistical analysis model was established. IMRT plans of 5 prostate cancer patients were randomly chosen from the ADAC Pinacal 7.6 version planning system. The beam parameters, objective functions of the target area and optimization parameters of the primary plan were kept unchanged. The main optimization parameters including EUD parameter a,weight (w) and EUD_(max) of OAR were adjusted in optimization procedure successively. The correlation analysis (CF) and optimization efficiency analysis (OF) were carried out on the results of the optimization. The optimal value of parameters (MORt{}) with the best dose distribution was obtained and substituted in the corresponding primary plan.After optimization, the dose distributions of the two IMRT plans were compared. Results There were signif-icant differences with different optimization methods. The EUD parameter a and weight factor (w) almost had no effect on volume dose of OAR (OF < 0.01), though had obvious effect on the maximum dose and mean dose (OF≈1). The CF analysis showed that the correlation between the PTV ( V_(95)) volume and OAR dose was different when the EUD parameter a and w were applied for optimization. Meanwhile, the difference was proportional to the distance between the target area and OAR. The mean dose of OAR was decreased and the mean dose of PTV was more close to the prescription dose when the optimization parameters of the prima-ry plan were substituted with MOR{a} ,MOR{w} and MORt{EUD_(max)}. Besides, the DVH and isedose dis-tribution of the secondary plan were better. Conclusions The correlation statistical analysis model can be used to accurately determine the scope of optimization parameters in the IMRT planning procedure in prostate cancer, and an IMRT plan which fulfils the clinical requirement can be obtained efficiently.

Using Uniform Design to Optimize Expressive Conditions of rPA(K) in E.coli / 中国生物工程杂志

Using uniform design to optimize some relative factors influencing the expressing of t-PA variant-rPA(K) in E.coli system, and found the best expressive conditions. They were(by using 300ml culture fask): the volume of media was 25ml, inducing time was 5.3 hours, pH was 6.0, the concentration of IPTG was 0.1mmol/L, inducing time was 25℃, and best culture media was HD. After being optimized, the yield of expression had been improved from 0.16 to 0.48, and it was as 3 times as before. The results above will offer the basement for purification and renaturation of rPA(K).

Study on optimum program for treatment of hypertensive cerebral hemorrhage in acute phase / 中华中医药杂志

Objective:To discuss the effect of optimum program on hypertensive cerebral hemorrhage in acute phase.Methods:380 patients with hypertensive cerebral hemorrhage were selected.They were randomly divided into test group by given two agents(Xuezhongxiao/Zhongfengfangzhiling)+comprehensive rehabilitation(rehabilitation of modern acupuncture)+ medicine-based treatment +microinvasive surgical therapy,and control group by given Chinese medicines(Xuekang /Naoan capsule) + modern rehabilitation+ medicine-based treatment + craniotomy treatment.The curative effects was observed and compared between the two groups.Results:The test group was evidently superior to the constrol one in haematoma clearance rate,nerve functions recovery,extremity rehabilitation and symptoms improvement(P

Preparation and Quality Control of Warfarin Sodium Granules / 中国药房

OBJECTIVE:To prepare warfarin sodium granules(WSG)and to establish it’s quality control methods .METHO_DS:To prepare WSG with part.aeq.geometric method,to optimize the amounts of all sorts of agents in the formulation in terms of dissolution time and abilityof WSG by orthogonal experiment.To determin the content of WS by UV. RESULTS:The formulation was designed and optimized,the WSG’s size were evenly.The concentration of WS was linear within the range of 5.92～17.86?g/ml with r=0.9 998(n=7),the average recovery rate was 101.26%～101.84%(n=5)with the RSD lower than 1.0%.The solution dissolved by granules is stable within 10 days.CONCLUSIONS:The preparation method is simple and feasible,the content determination methods is accurate,realible and sensitive,suitable for the quality control of WSG.The dissolved solution can be divided in accurate doses.

A Study on the ROI Optimizing Technique for Accurate Breath Measurements in Sleep Apnea / 대한의료정보학회지

OBJECTIVE: A sleep apnea is the most frequent symptom among sleep disorders. As the number of aged people are increasing, research activities are also increasing to monitor sleeping disorders of the elderly who lives alone. We proposed a new processing algorithm to measure the quantity of breaths accurately. METHODS: We improved the conventional center-of-mass method and further apply the projection profile method. RESULTS: In this study a system that can monitors respiration non-invasively and automatically, by identifying the movement of the chest and abdomen using image processing technique during sleep, was implemented. We can see breathing status in real time based on the acquired breathing waves. To verify the designed system, the values from the polysomnography were compared and analyzed to validate the system accuracy. As a result, the mean accuracy is 96%. CONCLUSION: We can simply monitor the sleep apnea with no sleep interferences.

On the Reasonable Utilization of Health Resources from the "Neonatal Deaths Incident" / 中国医学伦理学

Lots of problems has exposed in medical system,especially in unreasonable utilization of health resources.This article,from the viewpoint of utilization of health resource,analyzes current problems and countermeasures of the reasonable utilization of health resources.

Meditation on Optimization of the teaching in Medial ethics / 中国医学伦理学

According to the theory of optimization by ???? ??????????????(俄).this essay propounds two ideal about medical ethics of ethics and the clinic practice.The second involves the optimize methodology including self-study.classroom teaching and case discussion;Via multimedia and network.

Study on Optimized Extraction of Fructus Schisandrae Chinensis / 中国药房

OBJECTIVE: To optimize the extraction process of Fructus Schisandrae Chinensis. METHODS: Taking the contents of schizandrin, schisantherin A, deoxyschizandrin, r-schizandrin as the indexes, the influence on the extraction process by extract solvent and medicinal material particle diameter was examined, and the extraction parameters were optimized. RESULTS: Active components of Fructus Schisandrae Chinensis, after the medicinal material being crushed, can be effectively utilized through extracting by alcohol. The optimized extraction parameters were as follows: the medical material being ground into 40 meshes, extracted twice by 70% alcohol, 2 hours per time. CONCLUSION: The optimized extracting process works better than current technique adopted for formulated granule preparation, and can ensure quality to the highest degree.