Influence of visceral lipids obesity on the early postoperative complications after radical gastrectomy / 中华胃肠外科杂志

Objective: To investigate the effect of visceral fat area (VFA) on the surgical efficacy and early postoperative complications of radical gastrectomy for gastric cancer. Methods: A retrospective cohort study method was used. Clinicopathological data and preoperative imaging data of 195 patients who underwent D2 radical gastric cancer surgery at the First Affiliated Hospital of Xi'an Jiaotong University from January 2014 to December 2017 were analyzed retrospectively. Inclusion criteria: (1) complete clinicopathological and imaging data; (2) malignant gastric tumor diagnosed by preoperative pathology, and gastric cancer confirmed by postoperative pathology; (3) no preoperative complications such as bleeding, obstruction or perforation, and no distant metastasis. Those who had a history of abdominal surgery, concurrent malignant tumors, poor basic conditions, emergency surgery, palliative resection, and preoperative neoadjuvant therapy were excluded. The VFA was calculated by software and VFA ≥ 100 cm2 was defined as visceral obesity according to the Japan Obesity Association criteria . The patients were divided into high VFA (VFA-H, VFA≥100 cm2, n=96) group and low VFA (VFA-L, VFA<100 cm2, n=99) group . The clinicopathological characteristics, surgical outcomes and early postoperative complications were compared between the two groups. Univariate and multivariate Logistic regression models were used to analyze the risk factors of early complications. Receiver operating characteristic (ROC) curve was used to analyze predictive values of VFA for early complications. Pearson's χ2 test was used to analyze the correlation between BMI and VFA. Results: There were no significant differences in terms of gender, age, American Society of Anesthesiologists physical status classification, preoperative comorbidities, preoperative anemia, tumor TNM staging, N staging, T staging and tumor differentiation, surgical method, extent of resection, and tumor location between the VFA-L group and the VFA-H group (all P>0.05). However, patients in the VFA-H group had higher BMI, larger tumor, lower rate of hypoalbuminemia and greater subcutaneous fat area (SFA) (all P<0.05). The VFA-H group presented significantly longer operation time and significantly less number of harvested lymph nodes as compared to the VFA-L group (both P<0.05). However, there were no significant differences in intraoperative blood loss, conversion to laparotomy and postoperative hospital stay (all P>0.05). Complications of Clavien-Dindo grade II and above within 30 days after operation were mainly anastomosis-related complications (leakage, bleeding, infection and stricture), intestinal obstruction and incision infection. The VFA-H group had a higher morbidity of early complications compared to the VFA-L group [24.0% (23/96) vs 10.1% (10/99), χ2=6.657, P=0.010], and the rates of anastomotic complications and incision infection were also higher in the VFA group [10.4% (10/96) vs. 3.0% (3/99), χ2=4.274, P=0.039; 7.3% (7/96) vs. 1.0% (1/99), P=0.033]. Multivariate logistic analysis showed that high BMI (OR=3.688, 95%CI: 1.685-8.072, P=0.001) and high VFA (OR=2.526, 95%CI: 1.148-5.559,P=0.021) were independent risk factors for early complications. The area under the ROC curve (AUC) of VFA for predicting early complications was 0.645, which was higher than that of body weight (0.591), BMI (0.624) and SFA (0.626). Correlation analysis indicated that there was a significantly positive correlation between BMI and VFA (r=0.640, P<0.001). Conclusion: VFA ≥ 100 cm2 is an independent risk factor for early complications after radical gastrectomy for gastric cancer.It can better predict the occurrence of above early postoperative complications.

Analyze the effect of keratometry on the calculation accuracy of intraocular lens diopter in patients with normal axial cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effect of keratometry on the calculation accuracy of intraocular lens(IOL)diopter in patients with normal axial cataract.METHODS:Totally 157 cases(157 eyes)with age related cataract were collected in Kaifeng Central Hospital from June 2020 to June 2021. Patients were divided into 3 groups according to keratometry: group A(53 eyes)(K<42D), group B(55 eyes)(42D≤K≤46D), group C(49 eyes)(K>46D). The IOL diopter was calculated by SRK/T, Hoffer Q, Holladay 2, Haigis, Kane and Barrett Ⅱ formulas respectively. Subjective optometry was performed after 1mo operation. The average refractive prediction error(RPE)and mean absolute error(MAE)were calculated, and their differences were compared and analyzed.RESULTS:There were significant difference between RPE of each formula and 0D in groups A and C(<i>P</i><0.05), and Barrett Ⅱ formula was significantly different with SRK/T, Hoffer Q, Holladay 2 and Haigis formula(<i>P</i><0.01), but was no significantly different with Kane formula in RPE(<i>P</i>>0.01). There was no significant difference in RPE between group B and 0D(<i>P</i>>0.05). The ratio of Barrett Ⅱ formula in MAE≤0.5D in group A was significantly higher than SRK/T, Hoffer Q, Holladay 2 and Haigis formula(all <i>P</i><0.01), but there was no significant difference compared with Kane formula(<i>P</i>>0.01). In group B, there was no significant difference among Barrett Ⅱ formula and the other formulas in the ratio of MAE≤0.5D and ≤1.0D(all <i>P</i> >0.01). In group C, the ratio of SRK/T and Hoff Q formula in MAE≤0.5D was lower than Barrett Ⅱ formula(all <i>P</i><0.01), and there were no significant difference among Barrett Ⅱ formula and the other formulas in the ratio of MAE≤1.0D(<i>P</i> >0.01).CONCLUSION:If K<42D or K>46D before operation, the commonly used formulas will produce refractive error, but the accuracy of Kane and Barrett Ⅱ formulas are still higher than other formulas.

Efficacy of laparoscopic proximal gastrectomy with double-tract reconstruction versus laparoscopic total gastrectomy with Roux-en-Y reconstruction for early upper gastric cancer / 中华胃肠外科杂志

Objective: To compare clinical efficacy between laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) and laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) in patients with early upper gastric cancer, and to provide a reference for the selection of surgical methods in early upper gastric cancer. Methods: A retrospective cohort study method was carried out. Clinical data of 80 patients with early upper gastric cancer who underwent LPG-DTR or LTG-RY by the same surgical team at the Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2021 were retrospectively analyzed. Patients were divided into the DTR group (32 cases) and R-Y group (48 cases) according to surgical procedures and digestive tract reconstruction methods. Surgical and pathological characteristics, postoperative complications (short-term complications within 30 days after surgery and long-term complications after postoperative 30 days), survival time and nutritinal status were compared between the two groups. For nutritional status, reduction rate was used to represent the changes in total protein, albumin, total cholesterol, body mass, hemoglobin and vitamin B12 levels at postoperative 1-year and 2-year. Non-normally distributed continuous data were presented as median (interquartile range), and the Mann-Whitney U test was used for comparison between groups. The χ(2) test or Fisher's exact test was used for comparison of data between groups. The Mann-Whitney U test was used to compare the ranked data between groups. The survival rate was calculated by Kaplan-Meier method categorical, and compared by using the log-rank test. Results: There were no statistically significant differences in baseline data betweeen the two groups, except that patients in the R-Y group were oldere and had larger tumor. Patients of both groups successfully completed the operation without conversion to laparotomy, combined organ resection, or perioperative death. There were no significant differences in the distance from proximal resection margin to superior margin of tumor, postoperative hospital stay, time to flatus and food-taking, hospitalization cost, short- and long-term complications between the two groups (all P>0.05). Compared with the R-Y group, the DTR group had shorter distal margins [(3.2±0.5) cm vs. (11.7±2.0) cm, t=-23.033, P<0.001], longer surgery time [232.5 (63.7) minutes vs. 185.0 (63.0) minutes, Z=-3.238, P=0.001], longer anastomosis time [62.5 (17.5) minutes vs. 40.0 (10.0) minutes, Z=-6.321, P<0.001], less intraoperative blood loss [(138.1±51.6) ml vs. (184.3±62.1) ml, t=-3.477, P=0.001], with significant differences (all P<0.05). The median follow-up of the whole group was 18 months, and the 2-year cancer-specific survival rate was 97.5%, with 100% in the DTR group and 95.8% in the R-Y group (P=0.373). Compared with R-Y group at postoperative 1 year, the reduction rate of weight, hemoglobin and vitamin B12 were lower in DTR group with significant differences (all P<0.05); at postoperative 2-year, the reduction rate of vitamin B12 was still lower with significant differences (P<0.001), but the reduction rates of total protein, albumin, total cholesterol, body weight and hemoglobin were similar between the two groups (all P>0.05). Conclusions: LPG-DTR is safe and feasible in the treatment of early upper gastric cancer. The short-term postoperative nutritional status and long-term vitamin B12 levels of patients undergoing LPG-DTR are superior to those undergoing LTG-RY.

Survey on the stunting of children under seven years of age in nine cities of China / 中华儿科杂志

Objective@#To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting.@*Methods@#According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi′an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions.@*Results@#Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ2=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ2=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ2=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ2=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ2=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ2=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ2=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499).@*Conclusions@#The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.

A case of imported furuncular cutaneous myiasis and cytochrome oxidase Ⅰ gene sequence analysis of the pathogenic Cordylobia anthropophaga / 中华皮肤科杂志

To report a case of imported furuncular cutaneous myiasis,and to analyze the sequence of the mitochondrial cytochrome C oxidase subunit Ⅰ (CO Ⅰ) gene of the pathogenic Cordylobia anthropophaga.A 33-year-old female patient had a travel history to Ghana and Cameroon in Africa 1 month prior to the presentation.No anti-mosquito measures were taken during her stay,and she hung up the laundries outside to dry for several times.Skin examination showed furuncular protuberances with diameters of 1-2 cm on the inner side of the left upper arm as well as on the outer side of the left chest,which were bright red and hard on palpation with irregular borders and a small hole on their central surface.Morphological identification revealed that the larva squeezed from the lesion was suspected as myiasis.After PCR amplification of the CO Ⅰ gene of the larva,an about 650-bp PCR product was acquired.Sequencing and BLAST analysis showed that this product was most closely related to the CO Ⅰ gene (GenBank accession number:FR719158.1) of Cordylobia anthropophaga isolated in Cameroon in 2010 with the sequence similarity being 99.84％,and they were grouped together on the phylogenetic tree.According to the clinical features and travel history of the patient and the sequencing results of the pathogenic Cordylobia anthropophaga,this case was confirmed as imported furuncular cutaneous myiasis caused by Cordylobia anthropophaga.

Clinical study of Centurion active-fluidics configuration for phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the effectiveness and safety of the active-fluidics configuration with Centurion phacoemulsifier in cataract surgery.<p>METHODS: One hundred and thirty-three eyes with Ⅱ-Ⅳ grades cataracts were enrolled in this randomized prospective study from October to December 2018. They were divided into two groups, the experimental group used active-fluidics configuration for cataract surgery, while the control group used gravity-fluidics configuration. Cumulative dissipated energy(CDE), aspiration time(AT)and estimated fluid used(EFU)of each patient were recorded during the operation, endothelial cell density(ECD)and central corneal thickness(CCT)were measured before and one day after operation.<p>RESULTS: The CDE, AT and EFU were significantly lower with the active-fluidics configuration than with the gravity-fluidics configuration(<i>P</i><0.05); ECD was slightly decreased and CCT was slightly increased in both groups 1d after operation, but there was no difference between the two groups(2056.06±308.10cells/mm2 <i>vs</i> 1997.26±297.55cells/mm2, 532.75±12.02μm <i>vs</i> 531.02±13.00μm; <i>P</i>>0.05). No serious ocular adverse events related to the study devices or device deficiencies were observed.<p>CONCLUSION:Centurion active-fluidics configuration can maintain constant intraocular pressure during the operation, improve the stability of anterior chamber effectively. So it is safer and more efficient than traditional gravity-fluidics configuration.

Analysis of corneal spherical aberration in age-related cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the distribution of corneal spherical aberration in age-related cataract.<p>METHODS: Retrospective study. Totally 217 cases of age related cataract(217 eyes)were collected in the Central Hospital of Kaifeng from August 2017 to August 2018. Patients were divided into 3 groups according to age: 50-60 years(63 eyes)in group Ⅰ, 61-70 years(107 eyes)in group Ⅱ, 71-80 years(47 eyes)in group Ⅲ. Pentacam anterior segment analysis was used to measure the anterior and posterior corneal K-readings. The corneal spherical aberration of anterior, posterior and total were calculated on an area of 6mm diameter by Zernike analysis and a descriptive study was used.<p>RESULTS:The Mean±SD of total corneal spherical aberration was 0.311±0.098μm for all the patients. Statically significant were found for the anterior and total corneal spherical aberration(<i>F</i>=34.434, 32.896; <i>P</i><0.05). The anterior, posterior corneal K-readings and posterior corneal spherical aberration had no correlation with age(<i>r</i>=0.040, 0.066, 0.097, <i>P</i>>0.05). The anterior and total corneal spherical aberration were positively correlated with age(<i>r</i>=0.506, 0.509, <i>P</i><0.05).<p>CONCLUSION:The total corneal spherical aberration in age-related cataract was slightly higher than that before. The anterior and total corneal spherical aberration increased with age, and then the posterior corneal spherical aberration was not.

Structural equation model analysis of mental health influencing factors in family caregivers of schizophrenic patients / 中华疾病控制杂志

@# Objective The structural equation model was used to analyze the influencing factors of mental health of family caregivers with schizophrenia, so as to provide scientific basis for targeted intervention measures. Methods On the basis of investigating the social dysfunction of schizophrenia patients and their family function, social support and mental health status, structural equation model was used to analyze the factors affecting mental health of caregivers and their effect indexes, the main fitting parameters included compare the fitted indices(CFI), goodness of fit index (GFI), the adjusted goodness of fit index(AGFI), normed fit index(NFI) and approximate error root mean square(RMSEA). Result The total score of psychological self-rating scale of carers was higher than that of normal people(all P<0.05). Only 19.0% of home care providers with schizophrenia felt no or little burden, 33.0% mild burden and 48.0% heavy burden. Structural equation model fitting index for: 2(58)=47.440, P=0.838, 2/df=0.818, the main fitting parameters GFI=0.968、AGFI=0.943, CFI=1.000, NFI=0.973, RMSEA=0.000, model fitting effect was good. The total effects of social support, family care, patient social function and care burden on the mental health of family caregivers were -0.016, -0.197, 0.114 and 0.118, respectively. Conclusions The family caregivers of schizophrenia have serious mental health problems, and the burden of care is heavy. improving social support, family care and social function of patients is an effective way to improve their care burden and mental health level.

Abnormal coagulation function in myeloproliferative neoplasms / 中国实用内科杂志

Myeloproliferative neoplasm is a clonal hematopoietic stem cell disease, which is often complicated by coagulation dysfunction, manifested as thrombosis and bleeding tendency. The mechanism of coagulation dysfunction in myeloproliferative neoplasm is unclear, which may be the result of multiple factors, such as proliferation and activation of leukocyte, abnormality of platelet and its receptors, JAK2V617 F mutation, vWF consumption and drugs. High-risk patients should be assessed to prevent and reduce adverse events.

Clinical and radiological results of thoracic and lumbar fracture and dislocation treated with posterior transforaminal decompression and interbody fusion / 中国骨伤

OBJECTIVE@#To evaluate the clinical and radiological results of patients with thoracic and lumbar fracture and dislocation treated by posterior transforaminal decompression and interbody fusion.@*METHODS@#From June 2010 to June 2017, posterior transforaminal decompression, interbody fusion combined with pedicle screw fixation were performed in 21 patients with thoracic and lumbar fracture and dislocation. Their clinical and radiological data were collected and retrospectively analyzed, including 15 males and 6 females, aged from 25 to 58 years with an average of 45 years old. According to the criterion of American Spinal Injury(ASIA), preoperative neurological function was graded A in 3 cases, B in 7 cases, C in 6 cases, D in 4 cases and E in 1 case. Operative time and intraoperative blood loss and correlative complications were recorded. And VAS score, ODI and Cobb angle were evaluated before and after surgery. The improvement of neurological function was also analyzed at the final follow-up. Intervertebral bony fusion was observed during the follow-up by CT three-dimensional reconstruction.@*RESULTS@#The operative time was 150 to 240 min with an average of (192±47) min. The intraoperative blood loss was 380 to 750 ml with an average of(603±120) ml. Dura sac tearing and cerebral fluid leakage occurred in 3 cases and were repaired during operation; superficial wound infection occurred in 1 case, and got healing after dressing change. The postoperative follow-up duration was 24 to 45 months with an average of(37.0±9.5) months. VAS score was improved from preoperative 8.9±0.4 to immediately postoperative 4.2±1.3(<0.05). At the final follow-up, VAS score decreased further to 3.6±0.8. ODI was decreased from preoperative (95.30±3.52)% to (32.51±6.30)% at the final follow-up (<0.05). Cobb angle was corrected from preoperative (21.2±8.8)° to immediately postoperative(2.3±3.1)° (<0.05). At the final follow-up, Cobb angle was (3.2±2.5)°, showing no significant difference with immediately postoperative value. The neurological function was grade A in 3 cases, B in 3 cases, C in 5 cases, D in 6 cases and E in 4 cases at the final follow-up. All the patients got solid intervertebral bone fusion in 8 to 13 months after operation, with an average fusion time of (10.3±2.5) months.@*CONCLUSIONS@#For the patients with thoracic and lumbar fracture and dislocation mainly involving intervertebral disc and endplate plane, posterior transforaminal decompression and interbody fusion not only is less invasive, but also can effectively reconstruct spinal three column and obtain good biomechanical stability. And, it is beneficial for the good recovery of neurological function.

Effect of Simiao Yongan Tang on Permeability of Vasa Vasorum of Atherosclerotic Plaque / 中国实验方剂学杂志

Objective:To observe the effect of Simiao Yongan Tang on the pathologic morphology of atherosclerosis (AS) vulnerable plaque and the permeability of vasa vasorum (VV), and to explore its intervention mechanism with VV as the target. Method:Healthy male ApoE-/- mice were randomly divided into model group, Simiao Yongan Tang group(11.7 mg·kg-1·d-1)and simvastatin group(2.6 mg·kg-1·d-1). High-fat diet supplemented with 1.1% L-methionine was given to induce the animal model, while C57BL/6 mice were used as the control group. The model was evaluated after 8 weeks of feeding. After successful modeling, continued drug intervention was given for 8 weeks, and the pathological changes of the mouse aorta were observed by oil red O staining. The expression levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) proteins in the outer membrane of aortic root plaques were observed by immunohistochemical staining. Result:The results of oil red O staining showed that as compared with the control group, the plaque area of the aortic wall was significantly increased in the model group (PPPPPPConclusion:Simiao Yongan Tang can reduce the area of mouse aortic plaque, reduce the VV permeability of the outer plaque by regulating the expression of MMP-9 and TIMP-1, and stabilize the vulnerable plaque.

Clinical observation of intraocular lens calculation in eyes with previous radial keratotomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the accuracy of the Barrett True K intraocular lens(IOL)calculation formulas in eyes with previous radial keratotomy(RK).<p>METHODS: From February 2017 to February 2019, 42 eyes of 22 cataract patients with previous RK were selected in our hospital. Two methods were used to calculate IOL refraction before surgery: 1)Selected the smallest anterior surface K value in the area of 3mm central corneal diameter, used SRK/T formula, the target refraction was set at -1.0D; 2)Used Barrett True K on-line calculation formula, the mode of RK was selected and the target refraction was set at -1.0D. Three months after operation, the refractive state of the eyes was examined and the refractive errors calculated by the two methods were compared.<p>RESULTS: The average refractive error of Barrett formula method was 0.61(-0.37, 0.88)3mo after operation, which was significantly lower than that of traditional formula method 0.35(-0.25, 0.63)D(<i>P</i><0.05). There was no significant difference in absolute refractive error between the two methods(<i>P</i>>0.05). The refractive errors of traditional formula method in the range of ±0.5D, ±1.0D, ±2.0D accounted for 21%, 45%, 90% respectively. The refractive errors of Barrett formula method in the range of ±0.5D, ±1.0D, ±2.0D accounted for 31%, 74%, 100% respectively(<i>P</i><0.05).<p>CONCLUSION: Barrett True K online formula applied to cataract patients after RK can achieve satisfactory refractive status.

The Exploration of the Flexible Talent Introduction in County Level Public Hospital / 现代医院

To accelerate the development of talent team construction is the urgent issue in the county level public hospital. Introduction of high-level talents in a flexible manner to work in county level public hospital can promote the sustainable development of the hospital. In view of the reality of Binhai county people's hospital, the author analyzes the flexible recruitment, training, encouragement and management of talents, which helps promote the cultivation of medical personnel, enhance research capacity and medical technology.

Clinical Observation of Recipe for Clearing Heat and Removing Dampness Combined with Butyl Flufenamate Ointment in Treating Facial Seborrheic Dermatitis / 广州中医药大学学报

Objective To observe the clinical efficacy of Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment for the treatment of facial seborrheic dermatitis. Methods A total of 92 patients with facial seborrheic dermatitis were randomly divided into treatment group and control group,46 cases in each group. The treatment group was treated with oral use of Recipe for Clearing Heat and Removing Dampness combined with external use of Butyl Flufenamate Ointment, and the control group was only treated with external use of Butyl Flufenamate Ointment. The treatment for the two groups covered 4 weeks. Before treatment and on treatment day 7, 14 and 28, scores of clinical symptoms, related skin barrier function indexes,and the serum level of cathepsin S(Cat S)in the two groups were observed. Results(1)On treatment day 14,28,the total effective rate in the treatment group was 84.8％, 89.1％,and that in the control group was 65.2％,71.7％ respectively,the difference being significant(P < 0.05).(2)On treatment day 7,14,28, the scores of clinical symptoms in the two groups were obviously decreased(P < 0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.05).(3) On treatment day 7,14,28,facial sebum secretin,skin water content,and transepidermal water loss(TEWL) of the treatment group were improved to various degrees compared with those of the control group,the differences being significnat(P < 0.05 or P < 0.01).(4)On treatment day 28,serum Cat S of the two groups was markedly decreased(P < 0.01 compared with that before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.01). Conclusion Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment exerts certain effect for the treatment of facial seborrheic dermatitis.

Risk factors complicated cardiovascular and cerebrovascular diseases in patients with refractory hypertension / 心血管康复医学杂志

Objective: To explore risk factors for complicated cardiovascular and cerebrovascular diseases in patients with refractory hypertension (RH).Methods: Clinical data of 536 RH patients, who were treated in our hospital from Jun 2010 to Jul 2015, were retrospectively analyzed.According to presence of cardiovascular and cerebrovascular diseases or not, patients were divided into complication group (n=217) and pure RH group (n=319).Results: Compared with pure RH group, there were significant rise in percentages of drinking and smoking, hypertension course, mean arterial pressure (MAP), mean systolic blood pressure, pulse pressure, serum uric acid (SUA), creatinine (Cr), total cholesterol and low density lipoprotein cholesterol (LDL-C), and significant reductions in high density lipoprotein cholesterol (HDL-C) mean diastolic blood pressure and mean heart rate in complication group, P<0.01 all.Multi-factor unconditional Logistic regression analysis indicated that hypertension course, SUA,MAP, Cr and LDL-C levels were independent risk factors for complicated cardiovascular and cerebrovascular diseases in RH patients (OR=1.014~3.217, P<0.05 or <0.01).Conclusion: Hypertension course,MAP,Cr,SUA and LDL-C are independent risk factors for refractory hypertension.Enhancing their monitor, prevention and treatment are important to reduce incidence rates of cardiovascular and cerebrovascular complications in patients with refractory hypertension.

Experimental Study of Si-Miao Yong-An Decoction Regulating Vasa Vasorum Remodeling in ApoE-/-Mice with Atherosclerosis Vulnerable Plague / 世界科学技术-中医药现代化

This study was aimed to observe the effect of Si-Miao Yong-An (SMYA) decoction intervention in atherosclerosis (AS) vulnerable plaque,and to further explore the action mechanism from the entry point of vasa vasorum (VV) neovascularization.Male ApoE-/-mice were randomly divided into the model group,simvastatin group and SMYA group.High-fat diet added 1.1％ L-methionine was fed for 8 weeks to establish the AS vulnerable plaque model.The C57BL/6 mice were used as control.After 8 weeks' continuous medication,mice were sacrificed.HE staining were used to observe the pathological changes of mice aorta;immunohistochemical staining was used to observe the VV density in AS plaque and aortic adventitia;macrophage infiltration in plaque was also detected;the blood-lipid changes of TC,TG,LDL-C and HDL-C were detected;western blot was used to detect essential proteins of HIF-1α-Apelin/APJ signal pathway.The results showed that SMYA decoction decreased the plaque area and the ratio of plaque area and lumen area,increased the minimum thickness of fibrous cap,which significantly improved the pathological feature of aortic plaque in mice.The function of increasing the minimum thickness of fibrous cap was obviously superior to simvastatin.SMYA decoction effectively suppressed the VV neovascularization and decreased the macrophage content.SMYA decoction effectively decreased the serum level of TC,TG and LDL-C;however,it had no effect on HDL-C.SMYA decoction decreased the protein expression of HIF-1α.Its function was obviously superior to simvastatin.SMYA decoction can down-regulate the protein expressions of Apelin,APJ,Phospho-MEK1/2 (Ser217/221),Phospho-p44/42 MAPK (Erk1/2) (Thr202/Tyr204) and Phospho-p70 S6 Kinase (Thr421/Ser424).It was concluded that SMYA decoction regulated the HIF-1α-Apelin/APJ signal pathway,suppressed VV neovascularization and stabilized AS vulnerable plaque.

Treatment Progress of Traditional Chinese Medicine And Western Medicine on Regulating Vasa Vasorum for Atherosclerosis Vulnerable Plaque Stabilization / 世界科学技术-中医药现代化

The major clinical risk of atherosclerosis (AS) lesion is instability and vulnerability of plaque.Intraplaque vasa vasorum (VV) has structure defects with the characteristics of immature,irregular,fragile,and prone to extravasation and intraplaque hemorrhage due to the compromised structural integrity.It stimulates inflammatory reaction and provides channel for hemocyte and blood soluble composition entering into the plaque.Intraplaque VV can promote AS plaque formation and is closely related to the intraplaque hemorrhage,plaque rupture and occurrence of clinical cardiovascular events.In-depth study of VV function and key signaling pathways related to AS pathological process are promising to fundamentally prevent vulnerable plaque development,unstable plaque rupture and its complications.This article summarized the effect and mechanism of VV in pathological process of AS and related treatment,in order to provide theoretical basis for stabilization of AS vulnerable plaque.

Analysis of load resistance related body circumferences of students in teenager aviation schools / 军事医学

Objective To improve the load resistance ability of students in teenager aviation schools and carry out specialized training for the body situation and shape of students.Methods We selected students from 14 teenager aviation schools and measured their height,weight,and the circumferences of necks,chests,upper-arms,waists,hips,and thighs.We compared the data of these students from different areas and the parameters were analyzed statistically by correlation analysis.Results Totally 411 students from 6 southern schools and 403 students from northern schools were investigated.Their average body height,weight and body mass index (BMI) were (172.3 ± 4.39) cm,(62.7 ± 7.3) kg,and (21.1 ± 2.23)kg/m2 respectirely.Students from northern schools were taller and heavier than those from southern schools (P ＜ 0.05).There was no difference between students from northern and southern schools in BMI.Compared with the domestic average levels of height,weight and chest circumference of teenagers aged 14 to 17,students of teenager aviation schools were higher,but there was no difference in weight or chest circumference.The average circumferences of the chest,neck,left upper-arm,right upper-arm,waist,hip,left thigh and right thigh were (83.1 ± 5.06),(34.7 ±3.07),(25.2±2.33),(25.5 ±2.30),(73.4 ±6.73),(89.7 ±5.89),(50.1 ±5.22),and (50.2 ±5.27)cm,respectively.According to the data,students from northern schools had a bigger chest circumference and thigh circumference but a smaller neck circumference and upper-arms circumference than those from southern schools (P ＜ 0.05).The correlation coefficient between BMI and the circumferences of the chest,neck,left upper-arm,right upperarm,waist,hip,left thigh and right thigh was 0.2201,0.1066,0.2466,0.2499,0.2291,0.2149,0.2299,0.2264,respectively.All of them were statistically significant (P ＜ 0.0001).Conclusion Load resistance related parameters of students in teenager aviation schools are not different from the domestic levels,which points to the urgent need for load resistance ability training for these students.Some parameters vary between areas.BMI is positively related to those load resistance parameters.Based on regional variations and regularities found in this study,specialized load resistance ability training could be made more efficient.

Effect of salvianolic acid A on retinopathy and its mechanism in ZDF rats / 中国比较医学杂志

Objective To observe the intervention effect of salvianolic acid A ( SAA) on retinopathy of Zucker diabetic fatty ( ZDF ) rats and explore the possible action mechanism of SAA to prevent and treat diabetic retinopathy ( DR) . Methods Thirty-two 7-8-week old ZDF rats were taken and fed with Purina rat chow for 4 weeks. The ZDF rats were equally divided by the blood glucose into model group, 0. 5 mg/kg SAA group, 1. 0 mg/kg SAA group and metformin ( Met) group. 8 Zucker lean ( ZL) rats were taken as control group. After 12-week administration, incidence of cataracts and retinal pathology was observed, and levels of GLU, TC and HbA1c in blood, transferrin ( TRF) and retinol binding protein ( RBP) in urine and levels of interleukin-1 ( IL-1 ) , interleukin-6 ( IL-6 ) , oxidized low density lipoprotein ( ox-LDL), malondialdehyde (MDA) and lipoprotein related phospholipase A2 (Lp-PLA2) activity in serum were measured. Results In the model group, GLU, TC, HbA1c , diabetic cataract incidence rate, retinal basement thickening and microangiopathy appeared in most of the rats. The levels of TRF and RBP in urine and levels of IL-1, IL-6, ox-LDL, MDA in serum were significantly increased, and Lp-PLA2 activity was also significantly increased. After SAA administration, the morbidity rate of cataract was reduced, and retinal pathological changes were improved in different degrees. The levels of TRF, RBP, IL-1, IL-6, ox-LDL, MDA and Lp-PLA2 activity was decreased. Conclusions SAA can slow down the process of diabetic retinopathy in ZDF rats and reduce the incidence of cataract. The mechanisms of action may be related to inhibition of chronic inflammation, prevention of lipid peroxidation and reduction of Lp-PLA2 activity.

Clinical observation of capecitabine monotherapy or combination regimen in the treatment of advanced breast cancer / 中国生化药物杂志

Objective To explore the clinical effect and safety of patients with advanced breast cancer with capecitabine and gemcitabine combined with capecitabine treatment scheme. Methods 82 cases of patients with advanced breast cancer received treatment in our hospital from February 2014 to March 2016 were randomly selected and were randomly divided into control group and study group, 41 cases in each group.The control group using capecitabine monotherapy, the study group used capecitabine combined with docetaxel treatment. The therapeutic effects, safety and adverse reactions of the two groups were compared. Results The effective rate of treatment in the study group was 56.48 %, significantly better than that in the control group(34.28 %), the difference was statistically significant, The incidence of complications after treatment in the control group was 40.22 %, significantly higher than that in the study group (18.04 %), and the difference was statistically significant (P<0.05). Conclusion Capecitabine combined with docetaxel in the treatment of advanced breast cancer has good effect and low incidence of adverse reactions. It is worthy of recommendation and Application.