Efficacy observation of bortezomib combined with chemotherapy in treatment of relapsed/refractory acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective:To investigate the effectiveness and safety of bortezomib combined with conventional chemotherapy regimens for treatment of relapsed/refractory acute B lymphoblastic leukemia (B-ALL).Methods:Twenty patients with relapsed/refractory B-ALL treated with bortezomib combined with chemotherapy in Jiaozuo People's Hospital Affiliated to Xinxiang Medical College, Jiaozuo Coal Industry Group Central Hospital and the Second People's Hospital of Jiaozuo from September 2021 to June 2022 were collected, and their treatment response and prognosis were retrospectively analyzed.Results:The median age of the 20 patients was 49.5 years old (25.0-58.5 years old); 12 were male and 8 were female; 12 were relapsed and 8 were refractory. All patients completed 1 course of bortezomib (1.6 mg/m 2, subcutaneous injection on days 2 and 16) combined with chemotherapy. Before bortezomib treatment, there were 0 case of complete remission (CR), 7 cases of partial remission (PR) and 13 cases of non-remission (NR) in 20 patients, the objective remission rate (ORR) was 35% (7/20), and all were positive for minimal residual disease (MRD). After bortezomib treatment, there were 13 cases of CR, 3 cases of PR and 4 cases of NR, and the ORR was 80% (16/20); the MRD of all patients decreased, among which 13 cases (65%) turned to negative; the differences were statistically significant when comparing CR rate, ORR and MRD negative conversion rate before and after bortezomib treatment ( χ2 values were 65.41, 8.83 and 19.30, all P < 0.05). Four of the 20 patients developed central nervous system infiltration despite bone marrow remission, and one died from post-chemotherapy infection. Myelosuppression occurred in all patients, the incidence of infection was 90% (18/20), and the incidence of digestive system adverse effects was 75% (15/20). Conclusions:Bortezomib combined with conventional chemotherapy regimens is effective and well tolerated in the treatment of relapsed/refractory ALL, and has the potential to enable patients with multi-drug resistant relapse to overcome resistance and to achieve deep remission.

Surgical Safety of Elderly Hospitalized Patients Stratified by Age in General Surgery / 中国医学科学院学报

Objective To compare the surgical safety of elderly hospitalized patients in different age groups undergoing general surgery,and provide references for preoperative evaluation and treatment decision-making.Methods The inpatients ≥ 60 years old in the department of general surgery were selected from a national multi-center survey conducted from January to June in 2015 and from January to June in 2016.The patient characteristics and postoperative outcomes were described,and the risk factors for adverse postoperative outcomes of patients in different age groups were explored.Results The elderly patients (≥75 years old) accounted for 17.33%.The non-elderly patient (< 75 years old) group and the elderly patient (≥75 years old) group had significant differences in the proportions of patients with three or more chronical diseases (13.18% vs.5.36%,P<0.001),emergency surgery (16.64% vs.7.62%,P<0.001),American Society of Anesthesiologists score≥3 (48.68% vs.27.28%,P<0.001),and postoperative return to the intensive care unit(33.64% vs.12.00%,P<0.001).The occurrence of postoperative infectious complications showed no significant difference between the two age groups (7.29% vs.6.40%,P=0.410),while severe complications differed between the two groups (6.51% vs.2.60%,P<0.001).Besides,emergency surgery was a common independent risk factor for the two age groups.Conclusions Advanced age is not a contraindication to surgery of elderly patients.With consideration to patient's physical conditions and available surgical resources,elderly patients can still benefit from surgery.

Construction of sensitive indicators of nursing quality in dental clinic / 中国实用护理杂志

Objective:To construct a set of sensitive quality indexes for specialized nursing in dental clinics. These indicators are used to monitor and evaluate the quality of dental outpatient nursing care.Methods:Based on "structure-process-outcome" three-dimensional theory, through literature research, semi-structured interviews with 14 medical and nursing staff in Hefei Stomatological Hospital and two rounds of Delphi expert consultation with 19 stomatological management experts in stomatology departments of 19 first-class hospitals or third-class stomatological specialized hospitals in 11 provinces and cities in China, the three-level index system was determined, the calculation formula and data collection method of each index were clarified, and the weight of each index was determined by analytic hierarchy process.Results:The effective recovery rate of the two rounds of expert consultation was 100% and 89.47%. The expert authority coefficient were 0.905 and 0.906. Kendall′s W coefficients of the first, second and third level indicators in the second round of consultation were 0.206, 0.122 and 0.114. The differences were statistically significant ( χ2=7.00, 18.61, 149.23, all P<0.05). These indicators were assigned importance values ranged from 4.12 to 4.88 (>3.50), and coefficient of variations ranged from 0.07 to 0.23(<0.25). The final indicators included 3 first-level indicators, 10 second-level indicators and 26 third-level indicators. Conclusions:The research method of the constructed index is scientific, the content is reliable and the pertinence is strong. These indicators are conducive to the objective evaluation of the quality of dental outpatient care.

Characterization and phylogenetic analysis of the complete chloroplast genome of Lycopus europaeus / 药学学报

We intend to study the structural characteristics of Lycopus europaeus Linn. chloroplast genome and compare the evolutionary relationship of species from Lamiaceae with similar medicinal effects. The total DNA of Lycopus europaeus was sequenced using the Illumina Hiseq 4000 Sequencing platform and was assembled using NOVOplasty software. And then we annotated and analyzed the genome using the CPGAVAS2 online tool. We constructed the phylogenetic tree using the Stellera chamaejasme and Potentilla chinensis as the outgroup. The whole length of Lycopus europaeus chloroplast genome was 152 085 bp. A total of 132 genes were annotated including 88 protein-coding genes, 8 rRNA genes and 36 tRNA genes. Among them, 8 protein-coding genes (ndhB, rps7, rps12, rps19, rpl2, rpl23, ycf2, ycf15), 7 tRNA coding genes (trnM-CAU, trnL CAA, trnN-GUU, trnE-UUC, trnV-GAC, trnA-UGC, trnR-ACG) and 4 rRNA coding genes (rrn16s, rrn23s, rrn4.5s, rrn5s) are located in the IR region. There are 13 protein coding genes [rps16, rps19 (×2), atpF, rpoC1, rpl2 (×2), petB, petD, rpl16, ndhB (×2), ndhA] each contains one intron, two protein-coding genes (ycf3, clpP) each contain two introns, and 8 tRNA coding genes each contain one intron. A total of 34 SSRs were detected in the chloroplast genome of Lycopus europaeus. Phylogenetic analysis revealed that two species in the Lycopus genus, four species in the Dracocephalum genus, Glechoma longituba, two species in the Mentha genus and Prunella vulgari, in total 10 species are most related. The complete genome sequence of Lycopus europaeus was obtained and analyzed, which clarified the evolutional relationship between the species of Lycopus europaeus and in the Lamiaceae family.

Analysis and suggestions on harvest period standards of plant medicinal materials in 2020 edition of Chinese Pharmacopoeia / 中国中药杂志

The improvement of the harvest period standards is critical in the quality control of Chinese medicinal materials. The present study statistically analyzed the harvest period standards of plant medicinal materials in the 2020 edition of Chinese Pharmacopoeia(Vol.Ⅰ) and put forward the existing problems and suggestions based on herbal records and modern research to provide references for the improvement of the standards. According to the statistical analysis, in 499 types of plant medicinal materials, harvest period standards are recorded under 486 types, accounting for 97.4%, and are lacking in the remaining. Only one medicinal material(Stellariae Radix) is recorded with the standard of the harvest year. The standards of the harvest season and phenological period are recorded under 233 types, accounting for 46.7%. For 237 types, only harvest season is specified, accounting for 47.5%, and for 15 types, only harvest phenological period is specified, accounting for 3.0%. Among 222 types mainly derived from cultivation and 51 types from wild resources and cultivation, only 11 types are recorded with harvest period of cultivated products. Only Stellariae Radix is recorded with the harvest period standards for the wild and cultivated products separately. The harvest period standards of plant medicinal materials with different medicinal parts have certain rules to follow. The main problems about the harvest period standards are discovered. Specifically, no harvest period standards are recorded under 13 types of plant medicinal materials. Almost all perennial cultivated medicinal materials are not recorded with harvest year standard. No phenological period standard is found under 250 types of plant medicinal materials. There is no clear distinction between the harvest period standards of cultivated and wild products. The evidence for harvest period standards of 26 types of plant medicinal materials that can be harvested all year round is insufficient. As a result, it is proposed to strengthen basic research in response to the above-mentioned problems and improve the harvest period standards as soon as possible to ensure the quality of Chinese medicinal materials.

Predictors and Dynamic Nomogram to Determine the Individual Risk of Malignant Brain Edema After Endovascular Thrombectomy in Acute Ischemic Stroke

Background@#and Purpose This study aimed to construct an optimal dynamic nomogram for predicting malignant brain edema (MBE) in acute ischemic stroke (AIS) patients after endovascular thrombectomy (ET). @*Methods@#We enrolled AIS patients after ET from May 2017 to April 2021. MBE was defined as a midline shift of >5 mm at the septum pellucidum or pineal gland based on follow-up computed tomography within 5 days after ET. Multivariate logistic regression and LASSO (least absolute shrinkage and selection operator) regression were used to construct the nomogram. The area under the receiver operating characteristic curve (AUC) and decisioncurve analysis were used to compare our nomogram with two previous risk models for predicting brain edema after ET. @*Results@#MBE developed in 72 (21.9%) of the 329 eligible patients. Our dynamic web-based nomogram (https://successful.shinyapps.io/DynNomapp/) consisted of five parameters: basal cistern effacement, postoperative National Institutes of Health Stroke Scale (NIHSS) score, brain atrophy, hypoattenuation area, and stroke etiology. The nomogram showed good discrimination ability, with a C-index (Harrell’s concordance index) of 0.925 (95% confidence interval=0.890–0.961), and good calibration (Hosmer-Lemeshow test, p=0.386). All variables had variance inflation factors of 0.7, suggesting no significant collinearity among them. The AUC of our nomogram (0.925) was superior to those of Xiang-liang Chen and colleagues (0.843) and Ming-yang Du and colleagues (0.728). @*Conclusions@#Our web-based dynamic nomogram reliably predicted the risk of MBE in AIS patients after ET, and hence is worthy of further evaluation.

Xinmailong injection improving myocardial ischemia reperfusion injury in isolated-heart of rats / 解剖学报

Objective To observe the protective effect of Xinmailong injection ( XML ) on myocardial ischemia reperfusion (I/R) injury in rats model. Methods The levels of SPF 60 successful acute myocardial ischemia rat models were randomly divided into control group, I/R group and XML group( Different drug concentrations 50 mg/L, 100 mg/L, 200 mg/L, 400 mg/L). The control group was continuously given K-H nutrient solution for 2 hours, the other group was given respective different drug concentrations or K-H nutrient solution by Langendorff isolated heart perfusion method after ischemia 30 minutes. The following indicators were detected: Hemodynamics included heart rate (HR), left ventricular development pressure (LVDP) and ±dp/dtmax; the myocardial enzymes included creatine kinase (CK), creatine minase- MB (CK-MB), troponin-1 (Tn-I) and myoglobin (MYO), coronary flow and myocardial infarct size were observed. The expression of Bax and Bcl-2 in each group was detected by Western blotting and immunofluorescence. Results Xinmailong injection could alleviate LVDP and ±dp/dtmax; decrease the release of CK, CK-MB, Tn-I, MYO and the shrink area of myocardial infarction; increase the coronary flow; enhance heart rate fast and certain inhibition of myocardial apoptosis. Conclusion Xinmailong injection can alleviate the damage of cardiac function caused by myocardial ischemia/reperfusion injury.

The Recent HIV-1 Infections in Blood Donors of Fuzhou Zone / 中国实验血液学杂志

OBJECTIVE@#To investigate the recent HIV-1 infections of the blood donors in Fuzhou zone.@*METHODS@#The positive HIV antibody confirmatory samples in Fuzhou zone from 2012 to 2016 were collected and tested by LAg-Avidity EIA, and HIV long-term infections or recent infections were determined.@*RESULTS@#405 371 cases of blood donors were tested in the period from 2012 to 2016, and 94 HIV confirmatory positive samples were collected. 35 cases were recent infections determined by LAg-Avidity EIA, the annual HIV-1 incidences were 1.326‰, 0.845‰, 0.694‰, 1.148‰ and 0.364‰, the average incidences were 0.863‰. Among 94 cases of HIV confirmatory positive donors，58 cases were first donors and 36 cases were repeated donors, 17(29.3%) and 18 (50.0%) cases were recent infections respectively, which showed statistical significance（χ@*CONCLUSION@#The HIV-1 incidences were stable among blood donors in Fuzhou zone. The percentage of HIV-1 recent infections in repeated donors were more higher than that in first donors.

Advance in Development of Neurons and Glial Cells in Brain Tissue of Children with Autism Spectrum Disorder (review) / 中国康复理论与实践

Autism spectrum disorder is a group of neurodevelopmental disorders that occur in early childhood. The specific pathogenesis is not clear. Abnormal development of neurons and glial cells is a significant feature of patients with autism spectrum disorder. This article reviewed the changes in neurons, astrocyte, microglial cell and oligodendroglia cell in autism spectrum disorder.

Relationship between blood routine characteristics and clinical classification in 129 COVID-19 patients / 上海预防医学

Objective To investigate the characteristics of blood routine in 129 patients with COVID-19, and analyze the correlation between blood routine parameter changes and clinical classification. Methods A total of 129 COVID-19 patients were recruited and their blood samples were collected at the beginning and the end of treatment.The neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), lymphocyte-to-monocyte ratio(LMR) and C-reactive protein(CRP) were determined and used to calculate Δ NLR, Δ PLR, Δ LMR.The differences in these parameters were compared between the non-severe group (93 cases) and the severe group (36 cases).In addition, the relationship between the changes in blood routine test result and the prognosis of patients was determined. Results The average age of 129 patients was 46.9±17.4 years old, and the ratio of male to female was 1.2 ∶ 1.Thirty-five (35) cases (27.1%) had leucopenia (< 4×109/L) and 59 cases (45.7%) had lymphopenia (< 1.1×109/L).There were statistically significant differences in age, treatment days, blood routine indexes between these two groups.In all the patients, the differences between before and after treatment were statistically significant in the following: leukocyte number, neutrophil cell percentage, lymphocyte number, lymphocyte percentage, monocyte number, monocyte percentage.The differences in RBC, HGB, CRP, and NLR between the two groups before and after treatment were also statistically significant (P < 0.05). Conclusion The older COVID-19 patients have lower number of lymphocytes, higher NLR and PLR, lower LMR and higher CRP.They have a higher risk of progressing to severe disease.After treatment, there is an increase in the number of granulocytes, especially the number of lymphocytes, while a decrease in CRP and NLR.The change of lymphocyte count, NLR and CRP levels can predict the risk of severe COVID-19 and evaluate the therapeutic effect.

Comparative analysis of three complete chloroplast genomes of Inula genus with phylogenetic analysis of 49 plants from Carduoideae / 药学学报

italic>Inula japonica, Inula hupehensis and Inula linaariifolia are all medicinal plants of Inula L. in the Compositae family, and Inula hupehensis is endemic to China. In order to compare their genomic sequence differences and provide scientific basis for their germplasm conservation and development, we obtained and analyzed the complete chloroplast genomes of these three species. Total DNAs were extracted from fresh leaves and subjected to next-generation DNA sequencing. NOVOPlasty was used to assemble the chloroplast genomes from the sequence reads. CPGAVAS2 was used to annotate the genes and repeats in each genome. Lastly, phylogenomics analysis was conducted using RAxML. The results showed that the total length of the chloroplast genome of Inula japonica, Inula hupehensis and Inula linaariifolia is 150 754, 150 909, and 150 812 bp respectively, each consisting of a large single copy region, a small single copy region and a pair of inverted repeat regions. In addition, the G/C content of all three chloroplast genomes was approximately 37.7% and each encoded 111 unique genes, including 79 protein-coding, 28 tRNA and 4 rRNA genes. Meanwhile, 32, 33, 34 simple repeat sequences, 18, 22, 18 tandem repeat sequences and 33, 37, 38 scattered repeat sequences were identified in three species. Phylogenomic analysis showed that all three species of Inula L. and Pluchea indica were clustered together, with the relationship between Inuleae and Senecioneae closer, suggesting that Inuleae may have originated from the Senecioneae, not the Cardueae. The data in this study not only enriches the chloroplast genome database of Inula L., but also lays the foundation for the future studies of species identification, phylogenetic relationships, evolution history and genetic diversity of Inula species.

Investigation on an outbreak of human brucellosis in Yantai City Shandong Province / 中华地方病学杂志

Objective To analyze the epidemiological characteristics of an outbreak caused by human brucellosis in a farm in Yantai City,to explore the causes and transmission routes,and to provide evidence for prevention and control of brucellosis in Yantai City.Methods In 2014,an on-site investigation was conducted in a farm where brucellosis occurred in Yantai City,and case searches were conducted on exposed populations in the farm.According to the investigation questionnaire on epidemiology of brucellosis in Shandong Province,general information,clinical manifestation and high-risk behavior exposure information of the cases were collected;blood samples were collected and tested by tiger red plate agglutination test (RBPT) and tube agglutination test (SAT).Brucellosis was diagnosed according to the "Diagnostic Criteria for Brucellosis" (WS 269-2007).Results The first case was male,58 years old,farm worker.A total of 38 suspected cases were found.Eleven patients with positive RBPT and SAT≥1:100 (++) were confirmed cases.The confirmed cases were all male,with a median age of 52 years,ranging from 40 to 60 years old;5 farm workers and 6 construction workers;the onset time was mainly in June and July,a total of 7 cases;clinical manifestations mainly included excessive sweating,muscle and joint pain,fatigue,testicular swelling,etc.Of the 147 sheep in the farm,47 were positive by laboratory tests,accounting for 31.97％,which were the main sources of infection.High-risk exposures for farm workers included hand-delivered births (5 cases) and breeding for livestock (1 case);high-risk exposures for construction workers included entry and exit of sheep houses (6 cases) and handling of supplies in sheep houses (6 cases).Conclusions The epidemic is caused by direct contact with Brucella-infected sheep or caused by respiratory contact with brucellosis contaminated environment.It is necessary to strengthen the health education for prevention and control of the disease in key populations and improve the awareness of the disease.

Combined Chinese and western medicine for endometrial receptivity: A meta analysis of clinical trials / 国际中医中药杂志

Objective To systemically evaluate the effects of combined Chinese and western medicine in improving endometrial receptivity. Methods A search for relevant articles ran on the CNKI, WanFang, VIP, PubMed, EMBASE and Cochrane library. The randomized controlled trails of combined Chinese and western medicine therapy versus western medicine alone for improving endometrial receptivity were retieved The Revman 5.3 software was used for Meta-analysis according to Cochrane system evaluation method. Results A total of 7 randomized controlled trails involving 499 patients were included. There was statistically significant difference in the growth of clinical pregnancy rate [RR=1.78, 95％ CI (1.41, 2.26)], the increase of patients with endometrial thickness [MD=1.42, 95％ CI(1.27, 1.58)], the raise of the proportion with type A endometrium [RR=1.25, 95％ CI (1.07, 1.45)], the reduction of the patients with endometrial PI [SMD=-1.41, 95％ CI (-2.18,-0.64)]. There was no statistically significant difference in the reduction of endometrial RI [SMD=-1.11, 95％ CI (-2.52,0.30)]. Conclusions The therapy integrated Chinese and western medicine for endometrial receptivity is better than simple western medicine. But there is less literature on the high quality, suggesting that the methodology of clinical research should be further improved in the future.

Complete chloroplast genome of Allium chinense: comparative genomic and phylogenetic analysis / 药学学报

italic>Allium chinense belongs to the genus Alliums of the lily family. It can be used both as medicine and food. To date, the phylogenetic relationship of Allium species have not be resolved completely. Furthermore, there has been a lack of DNA barcode to distinguish closely related species. In this study, the complete chloroplast genome of A. chinense was obtained using next generation DNA sequencing and bioinformatic analysis, and compared with that from other Allium species. The genome is a circular molecule of 152 525 bp with a typical quadripartite structure. Genome annotation identified a total of 116 genes, including 81 protein-coding genes, 31 tRNA genes, and 4 rRNA genes. Analyses of sequences from six Allium species showed that the most diverse regions are found in the protein coding regions such as ndhA and ycf1 genes, and in the intergenic regions, such as ps16-trnQ, trnT-trnF, ndhF-rpl32, rpl32-trnL and rpl16-rps3. A phylogenetic tree was constructed using 58 protein coding sequences from 53 species. All branches showed strong support with bootstrap scores reaching 66%-100%, except those for the Lilium and Paris. Our results suggest that the completed chloroplast genome could solve the classification problems of these species. Using EcoPrimer software, we identified seven markers from the chloroplast genomes, which can be used to differentiate congeneric species. In summary, we have sequenced the complete chloroplast genome of A. chinense, carried out phylogenetic analysis and identified a series of genus specific DNA barcode sequences. The results have laid the foundation for the systematical determination of the phylogenetic relationship of Allium species and the differentiation of species using the genus specific primers.

Isolation and Identification of Main Flavonoid Glycosides of Dendrobium officinale from Danxia Species and Yunnan Guangnan Species / 中国实验方剂学杂志

Objective: To extract,isolate,purify and identify the structures of the flavonoid glycoside in Dendrobium officinale from two different origin places (Danxia species and Yunnan Guangnan species),and provide experimental reference for confirming the common flavonoid glycoside components in D. officinale. Method: ① 70% ethanol was applied to extract the total flavonoids in leaves of D. officinale from two different species. Organic solvents petroleum ether,acetic ether and water saturated n-butyl alcohol were used in turn to extract the crude extraction. Then AB-8 Macroporous resin,Sephadex LH-20 and ODS chromatographic column were applied to isolate and purify the water saturated n-butyl alcohol extraction fraction. The structures of flavonoid glycoside were identified by studying physicochemical property,applying modern spectroscopy method like HPLC,ESI-MSn,1H-NMR,13 C-NMR,etc. ② HPLC characteristic spectrum technique was used to analyse and compare the common flavonoid glycoside components in Dendrobium officinale from different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species). Result: Five flavonoid glycoside compounds were isolated from the crude extractions of the leaves of D. officinale from two different species,and they were identified as rutin,vicenin Ⅱ,viceninⅠ,violanthin and isoviolanthin. The characteristic spectrum of vicenin Ⅱ and viceninⅠwere detected in stems of D. officinale from four different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species),and vicenin Ⅱ had a better separation degree in the characteristic spectrum. However,the characteristic spectrum of violanthin and isoviolanthin were more obvious in Yunnan Guangnan species and Guangxi Tiepilan species,while rutin was obvious in the Danxia species. Conclusion: Vicenin Ⅱis the common flavonoid glycosides component in D. officinale from different origin places (Danxia species,Yunnan Guangnan species,Guangxi Tiepilan species and Zhejiang native species),and can be used as the internal reference material for the characteristic spectrum of D. officinale.

Effect of early restrictive fluid resuscitation on inflammatory and immune factors in patients with severe pelvic fracture / 中华创伤杂志(英文版)

Purpose:@#To study the effect of early restrictive fluid resuscitation (EFR) on inflammatory and immune factors in patients with severe pelvic fracture (SPF ).@*Methods:@#A total of 174 SPF patients in the Department of Orthopaedics, the First Affiliated Hospital of Chengdu Medical College from July 2015 to June 2018 were involved in this study and divided into EFR group (n = 87) and control group (n = 87) using the random number table method. Conventional fluid resuscitation (CFR) was performed in control group, and EFR was performed in EFR group. The incidences of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) during rescue, successful rescue rate, blood transfusion volume, fluid input, and resuscitation time were compared between the two groups. The parameters including prothrombin time (PT), hematocrit (HCT), platelet (PLT) and blood lactate (BL) at the 4th hour after fluid resuscitation were recorded. The levels of inflammatory factors (TNF-α, IL-6, CRP) and immune factors (CD3＋, CD4＋, CD8＋, CD4＋/CD8＋) were compared between the two groups before treatment and 7 days after treatment. The revised acute physiologic and chronic health evaluation system and the sequential organ failure assessment scores were adopted for evaluation before treatment and 7 days after treatment.@*Results:@#The incidences of ARDS and MODS during rescue in EFR group were significantly lower than those in control group (p=0.015 and 0.010 respectively), and the successful rescue rate in EFR group was significantly higher than that in control group (p = 0.011). The blood transfusion volume, fluid input, resuscitation time in EFR group were significantly lower than those in control group (p = 0.016, 0.002 and 0.001 respectively). At the 4th hour after fluid resuscitation, PT and BL in EFR group were significantly lower than those in control group (p = 0.021 and 0.003 respectively), while HCT and PLT in EFR group were significantly higher than those in control group (p = 0.016 and 0.021 respectively). On day 7 after treatment, TNF-α, IL-6, CRP and CD8＋ in EFR group were significantly lower than those in control group (p = 0.003, 0.004, 0.007 and 0.003 respectively), while CD3＋, CD4＋ and CD4＋/CD8＋in EFR group were significantly higher than those in control group (p = 0.004, 0.000, 0.007 respectively). On day 7 after treatment, the revised acute physiologic and chronic health evaluation (APACHE) system and the sequential organ failure assessment (SOFA) scores in EFR group were significantly lower than those in control group.@*Conclusion:@#EFR can effectively eliminate inflammatory factors, improve immune function, maintain the stability of blood components, reduce the incidences of ARDS and MODS, and elevate the successful rescue rate in patients with SPF.

Parkinson's disease with paroxysmal breath holding and hypoxemia as the manifestation of dyskinesia: a case report / 中华神经科杂志

Parkinson's drug-induced dyskinesia is a common complication after levodopa treatment,and its clinical manifestations are complex.A case of Parkinson's L-dopa-induced dyskinesia misdiagnosed as epilepsy in our hospital is reported.The patient,a 69-year-old male,was hospitalized on May 2,2018 due to "15 years of retardation,recurrent limb twitching with breathing for more than 6 months,sudden loss of consciousess for 10 minutes".The patient took madopar for a long time and had obvious drug complications.In July 2017,the use of rasagiline improved manifestations slightly.In November 2017,repeated limb twitches began to occur.The onset time ranged from several minutes to one hour,and there was a gradual occurrence of twitching accompanied by obvious breathing.On May 1,2018,the patient was sent to our hospital for emergency treatment after limb twitching again.Due to the long-term history of hormone use,and tranquilizers and antiepileptic drugs were used to control the condition of the patient,the patient was misdiagnosed as epilepsy at first.With the adjustment of drugs and the change of condition,the patient was finally diagnosed as Parkinson's L-dopa-induced dyskinesia.The clinical manifestations of the disease include peak dyskinesia,bipolar dyskinesia and dystonia.The pathogenesis of Parkinson's disease is not completely clear and its clinical manifestations are diverse.However,there are few reports of Parkinson's disease,whose manifestation is loss of consciousness due to paroxysmal breath holding and hypoxemia.Therefore,in order to diagnose epilepsy in patients with Parkinson's disease,the possibility of dyskinesia should be excluded first.Therefore,the rational use of drugs is particularly important in the middle and late period of Parkinson's disease.

Investigation of TCM Constitutions and Lifestyles of Subjects with Positive Tumor Marker Screening / 中国中医药信息杂志

Objective To explore the differences of TCM constitutions and lifestyles among the subjects with positive tumor marker screening and those with normal tumor marker screening. Methods Totally 245 subjects with positive tumor marker screening from September 2014 to December 2017 in Weihai area were selected as the observation group and 300 subjects with normal tumor marker screening were selected as the control group. Field questionnaire was used to investigate TCM constitutions and lifestyles. Results In the observation group, the ratio of constitution of yin-yang harmony was significantly lower than the control group, with statistical significance (χ2=207.483, P＜0.001). The ratios of constitution of phlegm-dampness, constitution of blood stasis, constitution of qi deficiency and constitution of qi stagnation were significantly higher than the control group, with statistical significance (P＜0.05). There was statistical significance between the 2 groups in irregular rest, heavy drinking, regular smoking, lack of exercise, irregular diet and partial eclipse (P＜0.05). CEA, a positive indicator of tumor markers in the observation group, was commonly found in constitution of phlegm-dampness (40.43％) and constitution of qi deficiency (22.70％); CA199 was commonly found in constitution of qi stagnation (38.71％) and constitution of qi deficiency (24.19％); AFP was commonly found in constitution of blood stasis (38.46％) and constitution of qi deficiency (23.08％); CA125 was commonly found in constitution of blood stasis (33.33％) and constitution of qi stagnation (19.05％); CYFRA21-1 was commonly found in constitution of phlegm-dampness (54.55％) and constitution of qi deficiency (22.73％); PSA was commonly found in constitution of phlegm-dampness (61.52％) and constitution of damp-heat (23.08％). Conclusion Effectively controling the distribution of TCM constitutions of subjects with positive tumor marker screening in Weihai area and understanding the influence of lifestyles on tumor markers can provide guidance for clinical improvement of patients' biased constitutions and reduction of positive indicators of tumor markers.

A Screening of Pre-chemotherapy Psychological Distress in Breast Cancer Patients and An Analysis of the Influencing Factors / 昆明医科大学学报

Objective To understand the degree of psychological distress of breast cancer patients beford chemotherapy, and to analyze the causes and influencing factors. Methods A cross-sectional study was conducted on 95 patients with prechemotherapy for breast cancer from September 2017 to December 2017 using a general data questionnaire and distress management screening measure. Results The score of psychological pain before chemotherapy of breast cancer was (4.92 ±2.23), among which 69 cases with significant psychological pain accounted for 72.63％ (DT score was greater than 4). The main causes of breast cancer patients' psychological distress ranking on the top 10 are: surgical scar, recurrence worry, arm activities difficulty, daily life was disrupted, anxiety, memory loss, housekeeping difficulties, poor communication with her husband, fatigue, change the appearance. Single factor analysis showed that age, family harmony had an effect on psychological pain scores (P＜0.05).It is found that family harmony is the protective factor of paychological pain when age and family relationship are included in multifactor analysis (OR＞1, P＜0.05). Conclusion There is an obvious psychological distress in breast cancer patients before chemotherapy; The age, family harmony of the patient were independent factors related to psychological distress; body symptoms, emotions and family problems are the key issues to focus on before chemotherapy.

Effect of Action Observation Therapy on Upper Limb Function in Children with Spastic Hemiplegic Cerebral Palsy / 中国康复理论与实践

@#Objective To explore the effect of action observation therapy (AOT) on upper limb function in children with spastic hemiplegic cerebral palsy,and the better program. Methods From March to November,2017,45 children with spastic hemiplegic cerebral palsy were randomly assigned to control group and AOT group.The control group was further divided into group A(n=11)and group B(n=11), and received conventional rehabilitation treatment and scenic-observation therapy, 20 minutes every time for group A,and 30 minutes every time for group B.AOT group was further divided into group C(n=10)and group D (n=11), and received AOT in addition, 20 minutes every time for group C, and 30 minutes every time for group D,five times each week for twelve weeks for all the groups.Before treatment,eight and twelve weeks af-ter treatment, they were assessed with hand grip strength, Upper Extremities Functions Test (UEFT), and Wee Functional Independence Measure(WeeFIM). Results After treatment,the hand grip strength and the score of UEFT were better in group D than in groups B and C(P<0.05),and were better at twelve weeks than at eight weeks(P<0.05).No significant difference was found in the score of WeeFIM among groups after treatment(P>0.05). Conclusion AOT could improve upper limp function in children with spastic hemiplegic cerebral palsy,and it's more ef-fective after more training.