Efficacy and safety of tenecteplase in the treatment of acute ischemic stroke：a meta-analysis / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of intravenous bolus of tenecteplase in the treatment of acute ischemic stroke （AIS）， in order to provide evidence-based support for the clinic’s choice of intravenous thrombolytic drugs. METHODS Randomized controlled trials （RCTs） about the efficacy and safety of tenecteplase versus alteplase （control） in the treatment of AIS were collected from PubMed， Embase， the Cochrane Library， Web of Science， Sinomed， CNKI， Wanfang Data， and VIP during the inception to June 2022. Two evaluators independently screened the literature， extracted data from the literature， assessed the bias risk of included study， and then conduct meta-analysis by using Stata 15 software. RESULTS A total of 8 literature were included， involving 2 129 patients. Meta-analysis results showed that the early improvement rate of neurological function [OR（95%CI）＝2.44（1.09，5.46），P＝0.030] and the good rate of neurological function recovery （modified Rankin scale score 0-2 after 90 days of intravenous thrombolysis treatment） [OR（95%CI）＝1.54（1.00，2.36），P＝0.048] were higher in 0.25 mg/kg tenecteplase group （medium dose） than alteplase group. According to meta-analysis of other outcome indicators （including recanalization rate， percentage of reperfusion lesions， excellent rate of neurological function recovery， the incidence rate of bleeding， the incidence rate of symptomatic intraventricular hemorrhage and all-cause mortality rate within 90 d）， the tenecteplase group had no statistically significant difference with alteplase group （P＞0.05）. CONCLUSIONS Compared with alteplase， medium dose of tenecteplase has some advantages in terms of early neurological function improvement and neurological function recovery， and it does not increase the risk of adverse events.

Investigation on mental health of general practice students in a medical school in Jiangsu Province / 中华全科医师杂志

A survey on mental health status was conducted during October 2021 to January 2022 among grade 2017—2021 medical students majored in general practice who received 3+2-year education integrated undergraduate study and residency training for assistant physicians in a medical school in Jiangsu province. The SCL-90 and the self-made scale were used to investigate the mental health status and the results were compared with the national norm, the norm of national physicians, and the norm of medical students in Jiangsu province. A total of 125 valid questionnaires were recovered, and the positive detection rate of SCL-90 scale was 17.6%. Compared with the national norm in 2015, the scores of forcing ( t=-2.47), the interpersonal sensitivity ( t=-2.00), the hostile ( t=-2.65), the paranoid( t=-3.14) and the psychiatric factor( t=-2.45) of the study group were significantly lower than those of the norm ( P<0.05). Compared with the norm of national physicians and the norm of medical students in Jiangsu province, the scores of all the items except the fear factor were lower than those of the norms ( P<0.05). In the study group there were no significant differences in the total score and all factors among students with different genders, different training stages, and different background. The total score of SCL-90 scale was negatively associated with the study performance and clinical skill mastery ( r=-0.18) and the sense of achievement ( r=-0.23, P<0.05). The study shows that the mental health status of this group of students is generally better than that of the several norms.

Survey on resident participation in community health management service / 中华全科医师杂志

Objective@#To survey the resident participation in community health management service and its influencing factors.@*Methods@#A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district. The questionnaire includes basic information of residents, understanding health management service, and the participation in the health management.@*Results@#Total 500 questionnaire were distributed, 449 copies were retrieved and 402 were valid. The rates of engagement in health archives, management of blood pressure, blood glucose and blood lipids, attending health education, regular health check-up, health follow-ups, and equipping family medicine kits were 62.2% (250/402), 71.0% (286/402), 49.5% (199/402), 59.9% (241/402), 72.6% (292/402), 66.9% (269/402), respectively. The rates of engagement of health archives, attending health education, regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (χ2=6.31, 4.09, 10.83, 10.83; P<0.05). The logistic regression analysis suggested that age, income, and understanding health management services were independent influence factors for resident active participation in health management.@*Conclusion@#The survey indicates that the young, high-income and healthy residents are more likely to participate in health management service, and the overall resident participation needs to be further improved.

Survey on resident participation in community health management service / 中华全科医师杂志

Objective To survey the resident participation in community health management service and its influencing factors.Methods A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district.The questionnaire includes basic information of residents,understanding health management service,and the participation in the health management.Results Total 500 questionnaire were distributed,449 copies were retrieved and 402 were valid.The rates of engagement in health archives,management of blood pressure,blood glucose and blood lipids,attending health education,regular health check-up,health follow-ups,and equipping family medicine kits were 62.2％ (250/402),71.0％ (286/402),49.5％ (199/402),59.9％ (241/402),72.6％ (292/402),66.9％ (269/402),respectively.The rates of engagement of health archives,attending health education,regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (x2=6.31,4.09,10.83,10.83;P＜0.05).The logistic regression analysis suggested that age,income,and understanding health management services were independent influence factors for resident active participation in health management.Conclusion The survey indicates that the young,high-income and healthy residents are more likely to participate in health management service,and the overall resident participation needs to be further improved.

Demands and needs of patients signing family doctor service in Nanjing Gulou district / 中华全科医师杂志

Objective To investigate the demands and needs of patients contracting for family doctor service in Nanjing Gulou district. Methods A questionnaire survey was conducted between July and December 2017 among residents in Nanjing Gulou district. The questionnaire included basic information of residents, willingness to sign service contract with family doctors, annual outpatient needs, demands of service mode, expectation for family doctor service, and willingness to pay. Results A total of 420 questionnaires were distributed and 415 questionnaires were valid. Multivariate analysis of variance suggested that age, income, and understanding of signing family doctor service were independent factors influencing signing intention (P<0.05).The variance analysis trend test indicated that the healthy people had highest willingness of signing, followed by the patients and the pregnant women (F=6.82, P<0.01). The number of annual outpatient service needs for healthy population, hypertensive patients, diabetic patients and pregnant women was(2.64±3.48),(7.02±4.80),(9.98±5.37)and(11.20±4.33)respectively (F=77.94, P<0.01). The average need of outpatient visit for health males was higher than that for females (P<0.01). There were significant differences in outpatient needs between patients with non-complicated hypertensionand complicated hypertension (P<0.01). The most anticipated services for healthy people were health records (74.26％,101/136), medical appointments (56.62％,77/136), and physical check-up (56.62％,77/136);those were management of blood glucose, blood pressure and body weight (70.13％, 108/154), regular testing (66.88％,103/154), follow-up supervision (66.23％,102/154) for chronic patients;those were regular physical examination (80.26％, 61/76), follow-up supervision (50.00％, 38/76) and health records (46.05％, 35/76) for pregnant women. The most popular health communication channel is WeChat, accounting for 44.10％(183/415), followed by outpatient clinic, telephone and internet services, accounting for 37.11％(154/415), 31.57％(131/415)and 11.08％(46/415)respectively. Among those who chose WeChat, 81.4％(149/183) were under 45 years old. And 86.27％(358/415)of people were willing to pay for corresponding signing fees. Conclusion Age, income, and understanding of general practice will affect residents′ willingness to sign the service contract with family doctors. Gender, disease spectrum and number of illnesses affect residents′outpatient service needs. Individualized family doctor service should be provided for people with different health needs.

Comparative experiment study of two kinds of methods for establishing SD rat chloasma model / 重庆医学

Objective To comparatively analyze the SD rat chloasma model established by using the two methods of progesterone injection and ultraviolet radiation.Methods The rat chloasma model was established by adopting the high and low doses of progesterone injection and ultraviolet irradiation.The plaque area was observed and the skin section was observed by light microscope.The SOD and MDA levels closely related with chloasma melanin deposition were detected.Results The significant pigment deposition on the back skin in the high dose progesterone group was seen by naked eye and the scattered pigment deposition was seen in the low dose progesterone group;significant pigment deposition could be found in the ultraviolet group.Compared with the control group,the MDA level of various tissues in the high dose progesterone group was increased,while the SOD level was decreased,serum and skin SOD level in the low dose progesterone group was decreased,the difference was statistically significant(P＜0.05).Serum and skin SOD level in the high dose ultraviolet group was decreased,while the MDA level was increased,the skin SOD level in the low dose ultraviolet group was decreased(P＜0.05),but the difference between the two groups was not statistically significant (P＞0.05).The melanin grains were heaped up as the small black body under light microscope,which in the progesterone group showed the clutter distribution,the difference between the high dose group and low dose group was significant;which in the ultraviolet group showed the linear dense arrangement and the intergroup had no significant difference.Conclusion Progesterone injection and ultraviolet irradiation all can successfully establish the SD rat chloasma model,and the constructing model effect and stability of ultraviolet irradiation are better.

Research progress on superparamagnetic iron oxide nanoparticles for targeted drug delivery / 国际生物医学工程杂志

Superparamagnetic iron oxide (SPIO) is a novel biomedical nanomaterial with surface effect,small size effect and macroscopic quantum tunneling effect.It has good biocompatibility and superparamagnetism which makes it widely used in targeted therapies.Compared to other nanodrug carriers,superparamagnetic iron oxide nanoparticles (SPIONs) have great potentials in nanodrug filed due to their properties such as intrinsic magnetic,good safety and the availability of surface modifications,etc.These properties provide the basis for their diverse applications in biomedical field.However,researchers are still concerned about the unpredictable toxicity and the changes in cell signal transduction and gene expression of SPIONs.In this paper,the research progress of SPIONs for drug targeting delivery was summarized.

Research progress on superparamagnetic iron oxide nanoparticles for targeted drug delivery / 国际生物医学工程杂志

Superparamagnetic iron oxide (SPIO) is a novel biomedical nanomaterial with surface effect,small size effect and macroscopic quantum tunneling effect.It has good biocompatibility and superparamagnetism which makes it widely used in targeted therapies.Compared to other nanodrug carriers,superparamagnetic iron oxide nanoparticles (SPIONs) have great potentials in nanodrug filed due to their properties such as intrinsic magnetic,good safety and the availability of surface modifications,etc.These properties provide the basis for their diverse applications in biomedical field.However,researchers are still concerned about the unpredictable toxicity and the changes in cell signal transduction and gene expression of SPIONs.In this paper,the research progress of SPIONs for drug targeting delivery was summarized.

Clinical Characteristic of 34 Patients with Extranodal Nasal Type NK/T-Cell Lymphoma / 昆明医科大学学报

Objective Analysis of clinical features and treatment of nasal type NK/T cell lymphoma, to improve the understanding of this special type of lymphoma.Method The clinical data of 34 patients with nasal type NK/T cell lymphoma confirmed by pathology were retrospectively analyzed.Result In 31 cases, 26 cases were EB virus (EBV) infection positive, recent Treatment Effectiveness in the positive group was significantly lower than the negative group (38.46%vs. 87.50%;P<0.05) . Follow up showed until October 2015, 19 of 34 patients died. Among them, 17 cases died of disease relapse or progression, 2 cases died of other diseases. 15 patients survived (11 of them were disease-free) and the median overall survival time was 37 months. The 2 year overall survival was related to clinical stage, B symptoms, EBV infection (the P values were 0.017/0.001, 0.005, and 0.039 respectively).Conclusion EBV infection is associated with patient's treatment response in NK/T-Cell Lymphoma; and the prognosis is associated with clinical features such as clinical stage, B symptom, and EBV infection.

Clinical value of interrupted inferior vena cava in prenatal diagnosis of isomerism / 中华围产医学杂志

Objective To analyze the ultrasonic features of interrupted inferior vena cava (IVC) and its relationship with related deformities so as to improve the prenatal diagnosis of isomerism.Methods Pregnant women who received prenatal care in Peking University People's Hospital or who were referred to our hospital for suspected malformation of fetus between January 2010 and December 2013 were enrolled in this study.Fetal echocardiography and abdominal transverse section were performed routinely.Spatio-temporal image correlation technology was used to further clarify interrupted IVC if azygos vein was broadened or IVC disappeared in the fetal abdominal transverse sections.Based on the presence of cardiac structural abnormalities,interrupted IVC was divided into isolated IVC interruption and complex IVC interruption.Neonatal echocardiography was performed in women with continued pregnancies.In women with terminated pregnancy,fetus was autopsied after induced labor.Results In total,12 cases of interrupted IVC were diagnosed,including 5 cases of isolated IVC interruption with full-term delivery and 7 cases of complex IVC interruption.Neonatal echocardiography,abdominal ultrasound were all normal in the 5 cases of isolated IVC interruption except for 3 cases complicated with sistus inversus viscerum.All the 7 cases of complex IVC interruption had induced labor because of some congenital cardiac abnormalities.Autopsy showed that 6 cases had left isomerism,and 1 case had right isomerism.Conclusions Interrupted IVC can be easily identified in prenatal diagnosis due to the typical ultrasonic features.Complication with some congenital cardiac abnormalities often indicates isomerism,especially left isomerism.

Clinical application of totally implantable central venous port / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).</p><p><b>METHODS</b>A total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Patient's profiles, indications of port system, early and delayed complications, and disposal methods were evaluated. There were 38 male and 1 969 female patients, aged from 21 to 85 years, with a mean of 47.6 years.</p><p><b>RESULTS</b>The mean duration of the TICVP system was (242 ± 12) days, ranging from 9 to 1 243 days. The achievement rate of puncture in the right jugular vein (99.76%) was the highest. Sonographic approach using the internal jugular vein were better than the external landmark-guided technique (99.80% vs. 96.34%, χ² = 29.905, P = 0.000). The rate of immediate complication was 0.80%, which included pneumothorax, hemothorax, lymphatic fistula and thrombosis. Early complications rate was 0.10%, which included pocket hematoma, catheter migration, venous thrombosis, port pocket infection, fibrin sheath formation. Late complications rate was 7.87%, which included catheter fracture, pinch-off syndrome, catheter-related bloodstream infection, fibrin sheath formation, catheter migration, extravasation, port inversion and port reveal. The rate of removal due to complications was 1.34% (27/2 007), and the early complication was higher (χ² = 8.053, P = 0.011).</p><p><b>CONCLUSIONS</b>The low incidence of complications suggests that TICVP is safe and reliable for long term intermittent venous access. The results support the use of TICVP in the oncology patients and patients requiring long-term intravenous therapy.</p>

Incidence of pocket hematoma after electrophysiological device placement：dual antiplatelet therapy versus low-molecular-weight heparin regimen / 老年心脏病学杂志（英文版）

Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this study, we investigated the incidence of pocket hema-toma formation after EPD placement in patients undergoing DAP therapy or an alternative low-molecular-weight heparin (LMWH) regimen. Methods This clinical observational study was performed from July 2010 to July 2012. In total, 171 patients were enrolled in the analysis after meeting the inclusion criteria. These patients were divided into two groups: 86 patients were treated with DAP therapy at the time of device implantation, and the DAP therapy was discontinued for 5 to 7 days and replaced with enoxaparin before device implantation in the other 85 patients. Adenosine phosphate (ADP)-mediated platelet aggregation and arachidonic acid-induced platelet aggregation were tested preoperatively. We compared the incidence of pocket hematoma between the two groups and the association of pocket hematoma develop-ment with ADP-mediated platelet aggregation and arachidonic acid-induced platelet aggregation.Results The incidence of pocket hema-toma in the patients who continued DAP was lower than that in the patients who replaced the dual antiplatelet regimen with LMWH (3.49%vs. 16.47%, respectively;X2 = 6.66,P < 0.01). Among the patients who continued DAP therapies, the rate of ADP-mediated platelet aggre-gation inhibition in patients with pocket hematomas was higher than that in patients without pocket hematomas. None of the patients under-going DAP or enoxaparin therapy developed pocket infection, thromboembolic events, or other serious complications. Multiple logistic re-gression analysis revealed that LMWH therapy was an independent risk factor for the development of pocket hematoma (RR = 0.054, 95%CI = 0.012-0.251). Furthermore, patients undergoing LMWH therapy were 5.1-fold more likely to develop pocket hematomas than were DAP-treated individuals.Conclusion Continuance of DAP therapy does not increase the risk of pocket hematoma formation after EPD placement.

The next-generation sequencing technology and application

As one of the key technologies in biomedical research, DNA sequencing has not only improved its productivity with an exponential growth rate but also been applied to new areas of application over the past few years. This is largely due to the advent of newer generations of sequencing platforms, offering ever-faster and cheaper ways to analyze sequences. In our previous review, we looked into technical characteristics of the next-generation sequencers and provided prospective insights into their future development. In this article, we present a brief overview of the advantages and shortcomings of key commercially available platforms with a focus on their suitability for a broad range of applications.

The Expression and Significance of TSP-1 in Breast Cancer / 天津医药

Objective: To investigate the correlation of thrombospondin-1(TSP-1) expression and angiogenesis and clinical pathologic factors in breast cancer. Methods:Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of TSP-1 mRNA in the primary breast cancer tissues and the tissues set apart 5 cm from the tumor. Im-munohistochemistry was used to detect the expressions of vascular endothelial growth factor (VEGF), c-erbB2, estrogen receptor (ER), progesterone receptor (PR) and microvessel density (MVD). All data were statistically analyzed. Results: The positive rate of TSP-1 was significantly higher in breast cancer than that in tissues set apart 5 cm from tumor (P < 0.05). The expression of TSP-1 was positively correlated with tumor size only (P < 0.05). MVD was lower in TSP-1 positive group than that of negative group (P< 0.05). Conclusion: The MVD was decreased with up-regulation of TSP-1 expression. Thrombospondin-1 may repress the angiogenesis in breast cancer.

Laparoscopic colorectal resection combined with simultaneous radiofrequency ablation for liver metastases / 中华消化外科杂志

Objective To assess the clinical value of laparoscopic colorectal resection combined with simultaneous radiofrequency ablation for liver metastases.Methods Twenty-two patients with colorectal cancer and synchronous liver metastases were treated by laparoscopie colorectal resection and simultaneous radiofrequency ablation(RFA)in Third People's Hospital of Chengdu from December 2001 to July 2006.Areas of colliquative necrosis were detected by contrast-enhanced computed tomography postoperatively.The outcomes were analyzed by chi-square test.Results Of all patients,8 had muhiple liver metastases,16 had complications.Thirty-one liver metastases were treated by RFA,and no complication oecurred.The mean postoperative hospital stay was(14±5)days,and there was no perioperative death.Five of the 22 patients were identified as incomplete ablation of the tumor,and the RFA was reperformed.The recurrence of liver metastases in the RFA necrotic zone was observed in 4 patients,and RFA was reperformed on 2 of them.Six patients died,and 2 of them died of liver metastases recurrence in the RFA necrotic zone.The recurrence rate of liver metastases and mortality was 18%(4/22)and 27%(6/22),respectively.The recurrence rate of patients with the diameter of the metastatic lession≥2.0 cm was significantly higher than those with the diameter of the metastatic lession＜2.0 cm(x2=5.867,P＜0.05).Conclusions Laparoseopie colorectal resection combined with simultaneous RFA provide a curative opportunity for colorectal cancer patients who are old and have multiple liver metastases,complications,poor tolerance of operation,and for patients whose tumors are difficult to resect.

Early repeated intermittent veno-venous hemofiltration in the treatment of severe acute pancreafitis / 中华胰腺病杂志

).The complication rate in RIVVH was lower than that in the control group (P<0.05).Conclusions Early RIVVH was effective in the treatment of SAP,and may be an option as adjuvant treatment measure.

Study on Pureparation Techniques of Jiawei Sini Granules / 中国中医药信息杂志

Objective To optimize the conditions of Jiawei Sini granules by inspecting the macroporous resin adsorption refined methods.Methods Orthogonal design was used with saikosaponin A,paeoniflorin,hesperidin and glycyrrhizin as indicators determined by HPLC.Results The AB-8 macroporous resin,the biggest per gram of resin adsorption capacity were saikosaponin A 2.8 mg,paeoniflorin 62.8 mg,hesperidin 49.6 mg,glycyrrhizin 84.9 mg,with the concentration of durg 0.5 g/mL,the resin column diameter-height ratio of 1∶7 and adsorption velocity of 2(BV/h).Conclusion Macroporous resin adsorption method can be used for refining Jiawei Sini Granules.

Diagnosis and treatment of liver trauma (a report of 210 cases) / 中国普通外科杂志

Objective　To explore the ideal effective treatment of liver trauma. Methods　The injury state, treating methods, effect and death causes of 210 patients with liver trauma were retrospectively analysed. Results　Of the patients, the liver trauma was in degrees Ⅳ Ⅴ Ⅵ in 88 cases (41.9%). Among 198 cases treated with operation, 39 underwent partial hepatectomy, 13 with gauze packing, 146 with debridement and suturing. 2 receieved inferior vena cava repairing, 4 liver atrery ligation. 19 patients died of serious injury, the death rate was 9% (19/210). Of the 19 cases, 12 (63.2%) died of great amount blood loss. Conclusions　The treatment of liver trauma should depend on the degree of injury. The death rate could be reduced by shortening the preoperative time and decreasing the amount of blood loss. Gauze packing can be applied as a temporary way to save the patients life.