Miniature Non-invasive Blood Pressure Measurement and Verification System / 中国医疗器械杂志

Mercury sphygmomanometer based on traditional auscultation method is widely used in primary medical institutions in China, but a large amount of blood pressure data can not be directly recorded and applied in scientific research analysis, meanwhile auscultation data is the clinical standard to verify the accuracy of non-invasive electronic sphygmomanometer. Focusing on this, we designed a miniature non-invasive blood pressure measurement and verification system, which can assist doctors to record blood pressure data automatically during the process of auscultation. Through the data playback function,the software of this system can evaluate and verify the blood pressure algorithm of oscillographic method, and then continuously modify the algorithm to improve the measurement accuracy. This study introduces the hardware selection and software design process in detail. The test results show that the system meets the requirements of relevant standards and has a good application prospect.

An Adaptive Method for Detecting and Removing EEG Noise / 中国医疗器械杂志

To solve the problem of real-time detection and removal of EEG signal noise in anesthesia depth monitoring, we proposed an adaptive EEG signal noise detection and removal method. This method uses discrete wavelet transform to extract the low-frequency energy and high-frequency energy of a segment of EEG signals, and sets two sets of thresholds for the low-frequency band and high-frequency band of the EEG signal. These two sets of thresholds can be updated adaptively according to the energy situation of the most recent EEG signal. Finally, we judge the level of signal interference according to the range of low-frequency energy and high-frequency energy, and perform corresponding denoising processing. The results show that the method can more accurately detect and remove the noise interference in the EEG signal, and improve the stability of the calculated characteristic parameters.

Iguratimod inhibits transforming growth factor-β 1 induced human lung fibroblast activation and collagen secretion via the Smad3/p300 pathway / 中华风湿病学杂志

Objective:To investigate the effect of iguratimod (IGU) on transforming growth factor-β 1 (TGF-β 1)-induced primary human lung fibroblasts (pHLFs) activation and collagen secretion. Methods:Mice pulmonary fibrosis (PF) models were established in vivo and were divided into three groups: the control group (CTR group), the Bleomycin (BLM) group and the BLM+IGU group, hematoxylin-eosin (HE) staining was used to observe lung morphology, and Masson staining was used to observe the degree of collagen accumulation in lung. Fibronectin and smooth muscle 22 (SM22) were detected by immunofluorescence, and the content of hydroxyproline in lung tissue was detected by chloramine-T method. In vitro, pHLFs were used to assess the effect of IGU on TGF-β 1 stimulation in four groups: CTR group, IGU group, TGF-β 1 group and TGF-β 1+IGU group, the apoptosis of cells was detected by flow cytometry, and the mRNA expression of collagen type Ⅰ (COL-Ⅰ) and collagen type Ⅲ (COL-Ⅲ) was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The protein levels of α-smooth muscle actin (α-SMA), fibronectin, p-Smad2, p-Smad3 and transcription coactivator p300 were detected by Western blot and immunofluorescence. One-way ANOVA was used for all data, and LSD- t test or Kruskal-Wallis test was used for pair comparison. Results:The content of hydroxyproline in CTR group, the BLM group and the BLM+IGU group was (0.552±0.075) μg/mg, (1.293±0.081) μg/mg and (0.833±0.053) μg/mg ( F=169.672, P<0.01) respectively. IGU reduced the content of hydroxyproline in the lung tissue of mice, reduced the accumulation of collagen in the lung, and thus reduced the degree of BLM-induced pulmonary fibrosis, and improved the pathological changes in the lung of mice. In cell experiments, IGU had no significant effect on apoptosis ( F=0.83, P=0.54). The relative expression levels of COL-Ⅰ mRNA in the CTR group, TGF-β 1 group and TGF-β 1+IGU group were (100.4±1.2), (299.0± 13.0) and (202.5±7.0) respectively ( F=468.7, P<0.01). The relative expression levels of COL-Ⅲ mRNA in the CTR group, TGF-β 1 group and TGF-β 1+IGU group were (99.8±1.9), (350.6±8.0) and (220.3±9.9) respectively ( F=468.7, P<0.01). The relative expression levels of α-SMA protein were (0.193±0.038) in CTR group, (0.530±0.061) in TGF-β 1 group, and (0.410±0.065) in TGF-β 1+IGU group ( F=35.620, P<0.01); The relative expression levels of fibronectin in CTR group, TGF-β 1 group, and TGF-β 1+IGU group were (0.200±0.020), (0.700±0.020) and (0.410±0.066) respectively ( F=123.326, P<0.01). The relative expression levels of p-Smad3 protein in CTR group, TGF-β 1 group, and TGF-β 1+IGU group were (0.120±0.020), (0.573±0.586) and (0.327±0.252) respectively( F=92.987, P<0.01); The relative expression levels of p300 in CTR group, TGF-β 1 group and TGF-β 1+IGU group were (0.180±0.055), (0.923±0.025) and (0.650±0.050) respectively ( F=207.676, P<0.01). IGU significantly decreased the mRNA expression levels of COL-Ⅰ and COL-Ⅲ induced by TGF-β 1, inhibited the protein expression levels of α-SMA, fibronectin, p300, and phosphorylation of Smad2/3. Conclusion:Our results revealed the beneficial effect of IGU on the inhibition of TGF-β 1-mediated pHLFs activation and collagen secretion via the Smad3/p300 pathway, thus suggest that it might act as an effective anti-fibrotic agent in preventing the progression of PF.

Association of alcohol drinking with the incident risk of type 2 diabetes among rural adult males in Deqing County， Zhejiang Province： a prospective cohort study / 上海预防医学

Objective:To investigate the association of alcohol drinking and the incident risk of type 2 diabetes in men and to provide evidences for early prevention of diabetes. Methods:Rural adult males without diabetes in Deqing County， Zhejiang Province were enrolled. A dynamic prospective cohort study was conducted. Data were collected through questionnaires， physical examination， experimental measurements and a electronic follow-up database. Cox multivariate regression was performed to assess the association of alcohol drinking and the incident risk of type 2 diabetes in men. Results:During the follow-up period （7.15±2.90 years）， 354 men developed diabetes， and the incidence rate was 4.15/1 000 person-years. After adjusting for confounding factors， the incident risk of type 2 diabetes among the men with high alcohol drinking frequency （≥7 times/week） and low single alcohol intake （0.1-19.9 g/occasion） was lower than that among non-alcohol drinkers， and the value of HR （95%CI） was 0.72 （0.56-0.94） and 0.54 （0.30-0.99）， respectively. Consumption of ≥40.0 g alcohol per occasion 3-6 times a week increased the incidence of type 2 diabetes， and consumption of <40.0 g alcohol per occasion over 7 times a week decreased the incidence of type 2 diabetes， with the value of HR （95%CI） of 1.53 （1.02-2.30） and 0.52 （0.28-0.99） respectively. Conclusion:Different alcohol drinking patterns affect the incident risk of type 2 diabetes among rural adult males in Deqing County. Further study on alcohol drinking and diabetes may have ethical and practical significance for the prevention and control of diabetes in rural China.

Prevention and control of malaria in Deqing County from 1951 to 2015 / 上海预防医学

Objective:To make a retrospective analysis on malaria epidemic history and control efforts in Deqing County from 1951 to 2015， and so as to provide a scientific basis for further consolidating the achievements after malaria elimination. Methods:Data on the epidemic， monitoring， prevention and control of malaria in Deqing from 1951 to 2015 were collected and analyzed by the method of descriptive research. Results:Totally 123 000 cases of malaria were reported in Deqing County from 1951 to 2015， and the annual average incidence was 529.61/100 000. There were 49 deaths with the mortality rate of 39.84/100 000. The epidemic peaked in 1960-1964 and reached its highest in 1963 with 21 942 cases and an incidence of 7825.25/100 000. After decades of the comprehensive prevention and control， eliminating malaria was accomplished in Deqing County in 2015. Conclusion:The prevention and control strategies/measures of malaria in different stages in Deqing County are effective. However， monitoring， health education and management for the migrant population， especial the returning workers from high-risk areas of malaria， should be further strengthened.

Molluscicidal effect of immersion with 50% wettable powder of niclosamide ethanolamine salt against Oncomelania hupensis on the soil surface and inside the soil layer in winter / 中国血吸虫病防治杂志

Objective To evaluate the molluscicidal effect of 50% wettable powder of niclosamide ethanolamine salt (WPNES) against Oncomelania hupensis on the soil surface and inside the soil layer by immersion method in winter. Methods O. hupensis snails were placed on the soil surface and 2, 5 cm and 10 cm under the soil layer outdoors in winter, and then immersed in 50% WPNES at concentrations of 1 mg/L and 2 mg/L for 1, 3 d and 7 d, while dechlorinated water served as controls. Snail mortality was observed following immersion with 50% WPNES on the soil surface and inside the soil layer. Results Following immersion with 50% WPNES at concentrations of 2 mg/L and 1 mg/L outdoors in winter, the 3-day corrected snail mortality rates were 98.0% and 76.0% on the soil surface, and the 7-day corrected snail mortality rate was both 100.0%. Following immersion with 50% WPNES at concentrations of 2 mg/L and 1 mg/L outdoors in winter, the 7-day corrected snail mortality rates were 95.5% and 85.6% 2 cm below the soil layer, 66.0% and 6.4% 5 cm below the soil layer. However, the 7-day snail mortality rate swere comparable between the 50% WPNES treatment group (at 2 mg/L and 1 mg/L) and controls 10 cm below the soil layer (both P > 0.05). Conclusion Immersion of 50% WPNES at a concentration of 2 mg/L for 7 days presents a high molluscicidal efficacy against O. hupensis on the soil surface and 5 cm within the soil layers in winter.

Analysis on Polymorphism of Platelet Antigen Gene in Shandong Han Population / 中国实验血液学杂志

OBJECTIVE@#To study the Polymorphism of the human platelet antigen(HPA) gene 1-17 and human leukocyte antigen(HLA) gene-A and B locus in Shandong Han population.@*METHODS@#A total of 962 samples from routine voluntary platelet donors were genotyped for HPA1-17 system and HLA-A site, B by PCR-SSP and PCR-SSOP respectively．Gene frequencies were calculated by counting. HPA1-17 and HLA genotype combinations were analyzed by Arelequin 3.5.@*RESULTS@#The gene frequencies of HPA-la, -1b, HPA-2a, -2b, HPA-3a, -3b, HPA-4a, -4b, HPA-5a, -5b, HPA-6a, -6b, HPA-15a, -15b were 0.9918, 0.0082, 0.9419, 0.0592, 0.5841, 0.4174, 0.9969, 0.0031, 0.9892, 0.0108, 0.9835, 0.0175,0.5488 and 0.4512, respectively． The most common HPA genotype combination was HPA-(1, 2, 4, 5, 6, 7-14, 16, 17) aa-3ab-15ab (0.2048). Moreover, HLA-A*2(0.3094) and HLA-B*13(0.1513) showed the highest frequency in their respective locus. The most common HLA genotype combination was HLA-A*2-B*13(0.1397) .@*CONCLUSION@#Distributions of HPA and HLA show high polymorphism in Shandong Han population. The ethnic and territorial difference of HPA distribution is also confirmed. It is imperative to establish local genetic database of volunteer platelet donors.

Differential expression analysis and regulatory network construction of miRNA and genes in osteoporosis / 医学研究生学报

ObjectiveMicroRNAs (miRNA) play an important role in the development and regression of osteoporosis. This study aims to screen for miRNAs and genes closely related to osteoporosis, and to complete the construction of a miRNA-mRNA regulatory network of osteoporosis.MethodsThe gene chip expression profile of osteoporosis was obtained through the GEO database, and the differentially expressed genes (DEGs) and miRNAs were analyzed and screened via GEO2R. We used volcanic maps to display differential genes and miRNAs, and completed the GO and KEGG pathway analysis through the David online database. The String online database is used to complete PPI protein network analysis. The TargetScan, miRTarBase and miRDB were used to predict the targeted genes. Finally, the PPI and miRNA-mRNA regulatory networks were visualized by Cytoscape software.ResultsWe obtained 15 differential miRNAs and 174 differentially expressed genes through screening. The GO enrichment analysis mainly focused on drug response, angiogenesis, ion transport, regulation of small GTPase mediated signal ransduction, adaptive immune response, etc. NF-κB signaling pathway and HIF-1 signal were obtained through KEGG enrichment analysis. We obtained 10 hub genes through the cytohubba plug-in. We also obtained 3065 targeted genes by processing of seven miRNAs, and then intersected them with 174 DEGs to obtain 44 intersection genes. Finally, we successfully constructed a regulation map of miRNA-mRNA network. The miR-194-5p is significantly up-regulated in osteoporosis.ConclusionThe miR-194-5p might play an important role in osteoporosis by regulating its target gene CDH2, which provides candidate targets for the diagnosis and treatment of osteoporosis.

The prevalence and risk factors of diabetes and hypertension in Deqing rural community / 中华疾病控制杂志

Objective This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors. Methods A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged≥18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested. Results The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI:3.24-7.54, P<0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI)<24 kg/m2(OR=0.48, 95% CI: 0.39-0.59, P<0.001) was the possible protective factor of diabetes mellitus, BMI<24 kg/m2(OR=0.60, 95% CI: 0.56-0.64, P<0.001), completing compulsory education(OR=0.54, 95% CI:0.49-0.59, P<0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P<0.001) were protective factors of hypertension, drinking(OR=1.18 , 95% CI: 1.08-1.29, P<0.001) was the possible risk factor of hypertension. BMI<24 kg/m2(OR= 0.26, 95% CI: 0.21-0.31, P<0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P<0.001) and drinking tea(OR=0.80, 95% CI:0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P<0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases. Conclusions The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.

Application of continuous two-layer suture of gallbladder incision with a single absorbable suture on laparoscopic gallbladder-preserving cholecystolithotomy / 中国内镜杂志

Objective To evaluate the clinical application of continuous two-layer suture of gallbladder incision with a single absorbable suture on laparoscopic minimally invasive gallbladder-preserving cholecystolithotomy. Methods The clinical data of 74 cases underwent laparoscopic minimally invasive gallbladder-preserving cholecystolithotomy were retrospectively analyzed. Main surgical procedures included the longitudinal incision of gallbladder wall, choledochoscopy and the removal of all stones and the closure of the gallbladder incision. The mucous incision was first closed using a 4-0 absorbable suture with continuous everting suture. Using the same suture, the seromuscular incision was then closed with continuous invering suture. The operation time, suturing time, complications and postoperative hospitalization time were also documented. Results Laparoscopic gallbladder-preserving cholecystolithotomy was successfully performed in all cases using the suturing technique introduced in Methods. The operation time was 33~78 min (average 45.11 ± 14.96 min). Suturing time for gallbladder incision was 9 ~ 22 min (average 14.86 ± 3.88 min). No severe complications occurred, such as bile leakage, peritonitis, residual gallstone, hemorrhage or infection. The postoperative hospitalization time was 2~4 d (average 3.21 ± 0.69 d). A postoperative follow-up of 3 ~ 62 months (average 35.50 ± 18.94 months) indicated gallbladder stone recurrence of 2 cases, with a recurrence rate of 2.7%. Continuous two-layer suture of gallbladder incision with a single absorbable suture is a safe, practical and reliable technique for the closure of the gallbladder incision in laparoscopic gallbladder-preserving cholecystolithotomy.

Influencing factors of postoperative complications of longitudinal fissure meningioma / 局解手术学杂志

Objective To evaluate the risk of microsurgery and reduce the incidence of postoperative complications in patients with lon-gitudinal fissure meningioma. Methods The clinical data of 106 patients with longitudinal fissure meningioma after microsurgery in the neu-rosurgery department of Xuzhou medical university from January 2011 to December 2017 were retrospectively analyzed.Longitudinal fissure meningioma were defined as the meningioma whose base were attached to the brain’s sickle sinus,sagittal sinus and the brain’s sickle sagit-tal sinus.Patients were divided into two groups according to whether there were postoperative complications.The gender,age,chief complaint symptoms,tumor base,tumor location,tumor size,tumor shape,MR enhancement,MR peritoneal edema, peritoneal adhesion of central sulcus vein and drainage vein,tumor invasiveness,tumor boundary,previous history of circulatory system were compared.Univariate analysis was per-formed on these factors to screen out the influencing factors of patients with postoperative complications.Binary logistic regression analysis was performed on the factors with statistical significance.Results Central sulcus vein and drainage vein adhesion were independent protective factors for postoperative complications.The risk of postoperative complications in patients without adhesion at peri-tumor stage was only 0.209 times of that in patients with adhesion.Conclusion For patients with longitudinal fissure meningioma,preoperative risk of postoperative com-plications can be assessed objectively according to the condition of central sulcus vein and drainage vein adhesion around the tumor.In the treatment of patients with obvious peritumoral vascular adhesion,the central sulcus vein and drainage vessels should be carefully protected to significantly reduce the incidence of postoperative complications.

Clinical analysis of pure spinal epidural cavernous hemangiomas / 局解手术学杂志

Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of pure spinal epidural cavernous hemangiomas.Methods We presented a case series of 6 patients with pure spinal epidural cavernous hemangiomas in our hospital from April 2012 to November 2016 with previous articles discussing their clinical presentation,radiological characteristics,surgical technique,pathological features,and functional outcome.Results All patients were diagnosed as pure spinal epidural cavernous hemangiomas by pathology.The cavernous hemangiomas were totally cut and patients recovered well after operations.All patients gradually improved neurologically and achieved a good outcome with no recurrence during the follow-up for 13 to 68 months.Conclusion Pure spinal epidural cavernous hemangioma is rare.It is easily confused with other spinal diseases.MRI is an important imaging examination method.Pathology is the method of diagnosis.Surgical resection is the main method of treatment,and the prognosis is good.

Study on medical technical support system in tent-form field medical system / 医疗卫生装备

Objective To develop a medical technical support module and box-type medical technical equipment so as to supply medical oxygen and water for the tent-form field medical system at field conditions.Methods The medical technical support module had its service orientation analyzed to determine its functional requirements and technical indexes, which involved in PSA oxygen generation technology with variable frequency,constant pressure and self-adaptability to altitudes as well as medical water preparation technology by integrated membrane separation. Box-type modules for medical oxygen generation and medial water preparation were trial-produced with the mode of integrated box and instruments as well as high-density polyethylene as the box material.Results The oxygen production was 1.3 Nm3/h,and the oxygen concentration was 92.7%.The flow volume of cleaning water and purified water was 433.7 and 37.2 L/h respectively at 25℃,and the water quality accorded with the relevant water quality indexes of GB 5749—2006 and the national pharmacopoeia(2010 edition). Conclusion This set of medical equipment can meet the design requirements and can effectively guarantee the medical oxygen and medical water needed for medical treatmentin field tent hospital under field conditions. [Chinese Medical Equipment Journal,2018,39(5):7-11]

Anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica / 中成药

AIM To study the anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica Lamn.and the mechanism.METHODS Both inflammatory rat model induced by carrageenan and pain model induced by formalin were applied to investigating the analgesic effect of extract of Toddalia asiatica Lam.ELISA kit was used to detect the contents of β-EP,5-HT and PGE2 in serum of carrageenan-treated rats,contents of TNF-αand IL-1β in skin tissue of inflammatory rats,and content of LTB4 in serum of formalin-treated rats;immunohistochemical method was used to observe the SP and FOS protein expressions in rat spinal cord.RESULTS The ethanol extract of Toddalia asiatica Lam.could significantly reduce the rate of toe swelling.In the formalin test,the ethanol extract of Toddalia asiatica Lam.reduced not only the total licking time,but also the content of PGE2,especially in the high dose group.And lowered serum 5-HT contents were observed in all the three dose groups,but a much better performance was found in both the high and low dose groups,and the high dose group's capability in increasing serum β-EP content was also noticed.TNF-α and IL-1β contents in skin tissue were reduced in various dose groups.Middle and high dose groups inhibited FOS protein expression.And the content of LTB4 in serum was obviously decreased in the high dose group.CONCLUSION The anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica Lam.may associate with its power in increasing β-EP in serum,decreasing PGE2,5-HT,LTB4 contents,reducing TNF-α,IL-1β contents in skin tissue,and lowering SP and FOS protein expressions in spinal cord.

Comparison of clinical effects between anterior cervical discectomy combined with corpectomy and cervical posterior single open-door laminoplasty in treating three-segment cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects between anterior cervical discectomy and fusion(ACDF) combined with anterior cervical corpectomy and fusion(ACCF) and cervical posterior single open-door laminoplasty with mini-titanium plate fixation in treating three-segment cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 63 patients (39 males and 24 females) with three-segment cervical spondylotic myelopathy underwent surgical treatment from March 2014 to March 2016 were retrospectively analyzed. Among them, 43 cases were treated by ACDF combined with ACCF(anterior group), and 20 cases were treated by cervical posterior single open-door laminoplasty with mini-titanium plate fixation(posterior group). Operative time, intraoperative blood loss, postoperative complications were compared between two groups. And according to JOA score to evaluate the clinical effect.</p><p><b>RESULTS</b>All the patients were follow-up from 16 to 40 months with an average of 25.8 months. Operative time of anterior group and posterior group were (123.70±6.21) min and(118.70±5.41) min, respectively, there was no significant difference between two groups(>0.05). Intraoperative blood loss of anterior group and posterior group were (85.23±7.51) ml and (107.18±9.41) ml, respectively, there was significant difference between two groups(<0.05). In anterior group, axial symptoms occurred in 6 cases, dysphagia in 1 case, and no C₅ nerve root palsy, hoarseness and choking cough were found, the incidence rate of complication was 16.3%(7/43); and in posterior group, axial symptoms occurred in 5 cases, C5 nerve root palsy in 1 case, and no dysphagia, hoarseness and choking cough were found, the incidence rate of complication was 30.0%(6/20); there was significant defference in incidence rate of complication between two group(<0.05). At 1 week after operation and final follow-up, the JOA scores of anterior group were obviously better than that of posterior group(<0.05).</p><p><b>CONCLUSIONS</b>Above-mintioned two surgical treatment for cervical spondylotic myelopathy can provide instantly stability, the method of ACDF combined with ACCF was obviously better that of the method of cervical posterior single open-door laminoplasty in intraoperative blood loss, the incidence rate of complications, clinical effect.Thus, for the treatment of three-segment cervical spondylotic myelopathy, the method of ACDF combined with ACCF would be firstly chosen.</p>

Overcoming bottlenecks in stroke treatment to comprehensively improve the efficiency of emergent treatment / 第二军医大学学报

To overcome the bottlenecks of treatment for stroke and comprehensively improve the treatment efficiency, we need to do three jobs: public health education, entering hospital in time, and specialized stroke treatment. Lack of public knowledge about stroke is the most important bottleneck restricting the treatment of stroke in China. Public health education is the foundation of treatment for stroke. Another bottleneck is whether the patients can enter a capable hospital in time. Optimizing the referral system, establishing a regional stroke network, and applying modern referral tools and information network can help the patients entering the target hospital in time. Specialized treatment of stroke refers to the quick access to professional treatment for stroke, which requires to avoid delay in hospital; and the effective strategy is to build and optimize the green channel for stroke treatment.

Hierarchical medical system piloted by Zhenjang Rehabilitation Group: practice and reflections / 中华医院管理杂志

Starting from the experiment of Zhenjiang Rehabilitation Group in establishing a tightly-organized medical association,the authors detailed the practices and outcomes of the group in deepening the system and mechanism reforms,promoting the hierarchical medical system,and other reforms of public hospitals.Key roadblocks and causes were identified,with reform measures proposed as well.

Treatment of posterior cruciate ligament avulsion fracture with rivet-assisted hollow nail:a case-control study / 中国骨伤

<p><b>OBJECTIVE</b>To retrospectively investigate the clinical effect of the rivet-assisted hollow screw in the treatment of posterior cruciate ligament avulsion fracture.</p><p><b>METHODS</b>Total 49 patients with knee cruciate ligament avulsion fracture in the ending point of the ligament from January 2010 to December 2014 were divided into the treatment group and the control group. Thirty-one patients in treatment group were treated with rivet-assisted double cannulate nail, including 13 males and 18 females, ranging in age from 38 to 51 years old, with a mean of (40.6±5.1) years old; according to Meyers classification, 23 cases of type 2, 8 cases of type 3; 5 patients were caused by the low energy injury and 26 patients were caused by the high energy injury. Eighteen patients in control group were treated with double gold hollow screw fixation, including 5 males and 13 females, ranging in age from 36 to 52 years old, with an average age of (4.16±4.7) years old; according to Meyers classification, 14 cases of type 2 and 4 cases of type 3;2 patients were caused by the low energy injury and 16 patients were caused by the high energy injury. The operation time, postoperative complications, fracture healing time and the last AKS scoring system were compared between the two groups.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 12 to 24 months, with an average of 14.2 months. The patients in treatment group had no displacement of fracture fragments and internal fixation failure. The results of AKS score:pain was 48.1±1.5, activity was 21.3±2.7, stability was 20.9±2.5, walking ability was 47.3±1.9, under the stairs ability was 43.4±2.1, the total score was 190.7±2.9. There were 2 cases in control group had fracture fragment displacement and 1 patient had nail withdraw. The results of AKS score:pain was 40.1±2.2, activity was 20.1±0.2, stability was 18.1±3.2, walking ability was 46.3±1.7, under the stairs ability was 40.2 ±1.3, the total score was 180.2±1.4. Therefore, the comparison of the above indicators, the results of the treatment group were better than those of the control group.</p><p><b>CONCLUSIONS</b>Rivet-assisted hollow screw fixation in the treatment of cruciate ligament avulsion fracture in the ending, has some advantages such as follows:accurate reduction, less postoperative complications and better postoperative knee function recovery, therefore it is an effective way to treat posterior cruciate ligament avulsion fracture.</p>

Effect of tripterygium glycosides and Danshen injection on blood coagulation mechanism in children with allergic purpura nephritis / 中国中药杂志

To observe the effect of tripterygium glycosides combined with Danshen injection on blood coagulation mechanism in children with allergic purpura nephritis, and investigate its treatment efficacy through a randomized controlled study. The results showed that before treatment, there were no significant differences in levels of D-D, APTT, PT, FIB and PLT between treatment group and control group; while after treatment, there were significant differences in levels of D-D, PT, FIB and PLT between two groups, but no difference in level of APTT. The effective rate was 90.38% in treatment group, significantly higher than 79.25% in the control group. There was no significant difference in incidence of adverse reactions between two groups. The results suggested that tripterygium glycosides combined with Danshen injection can enhance treatment efficacy and improve blood coagulation mechanism of children in the treatment of purpura nephritis, with high safety and no adverse effects.

Effect Analysis of the Implementation of National Essential Medicine System on the Drug Utilization of Outpa-tients in a Shanghai Community Health Service Center / 中国药房

OBJECTIVE:To provide reference for promoting the further implementation of national essential medicine system and rational use of drugs in community health service center. METHODS:Outpatients’information in Changqiao Street Communi-ty Health Service Center from Sept. 2,2009 to Nov. 25,2014 was collected to statistically analyze the drug variety,the number of prescriptions,the consumption sum and the DDDs before and after the implementation of essential medicine system and after the supplement of non essential medicines. RESULTS:Essential medicines occupied the main position of drug utilization in each stage, with substantial growth in respects of consumption sum and number of prescriptions;the sum of Chinese patent drugs and essential cardiovascular drugs occupied more than 50% of the total consumption sum and number of prescriptions,with higher growth rate;essential medicines occupied the top 10 in respects of consumption sum and DDDs,among which most were the drug varieties in“Shanghai supplement essential drugs in community health service center”(2010 Edition),with some overlap the varieties in“Na-tional Essential Medicine System”(2012 Edition);cardio-cerebrovascular drugs occupied the dominant position;the growth rates of cefotiam and atorvastatin took up the top 2 ranking in the list of consumption sum,while the growth rates of calcium carbonate D3 and irbesartan and hydrochlorothiazide took up the top 2 ranking in the list of DDDs. CONCLUSIONS:Essential medicine cata-log covers the common drugs in the community health service center,in which the rational use of Chinese patent drugs and antibac-terial deserves needs to be noticed. The clinical rational use of the essential medicines should be strengthened,the essential medi-cine catalog should be adjusted and non essential medicines should be supplied when necessary in order to truly meet the needs of patients and optimize the allocation of medical resources.