Dahuang Mudantang Alleviates Intestinal Injury in Rat Model of Acute Pancreatitis by Regulating HMGB1/RAGE/NF-κB Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Dahuang Mudantang in alleviating the intestinal injury in the rat model of acute pancreatitis via the high-mobility group box 1 （HMGB1）/receptor for advanced glycation endproduct （RAGE）/nuclear factor-κB （NF-κB） signaling pathway. MethodOne hundred and twenty SPF-grade Wistar rats received retrograde injection of 5% sodium taurocholate into the biliopancreatic duct for the modeling of intestinal injury in acute pancreatitis. The rats were randomized into blank， model， low-， medium-， and high-dose （3.5， 7， 14 g·kg-1， administrated by gavage） Dahuang Mudantang， and octreotide （1×10-5 g·kg-1， subcutaneous injection） groups （n=20）. The rats in blank and model groups received equal volume of distilled water by gavage. Drugs were administered 1 h before and every 12 h after modeling， and samples were collected 24 h after modeling. The general status of the rats was observed. The biochemical methods were employed to measure the levels of amylase （AMS） and C-reactive protein （CRP） in the serum. The enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of tumor necrosis factor （TNF）-α， interleukin （IL）-1β， and IL-6 in the colon tissue. The morphological changes of pancreatic and colon tissues were observed by hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to measure the expression levels of HMGB1， RAGE， inhibitor of NF-κB kinase （IKK）， and NF-κB suppressor protein α（IκBα）in the colon tissue. ResultThe rats in the model group showed poor general survival， writhing response， reduced frequency of defecation， and dry stool. The symptoms of rats in the model group were mitigated in each treatment group， and the high-dose Dahuang Mudantang showed the most significant effect. Compared with the normal group， the model group had elevated AMS and CRP levels （P<0.05）， which were lowered by Dahuang Mudantang （P<0.05）， especially that at the high dose （P<0.05）. Compared with the normal group， the modeling elevated that levels of TNF-α， IL-1β， and IL-6 （P<0.05）. Such elevations were lowered by Dahuang Mudantang （P<0.05）， and the high-dose group and the octreotide group showed better performance （P<0.05）. The modeling caused necrotic， congested， and destructed pancreatic and colonic tissues， which were ameliorated by the drugs， especially high-dose Dahuang Mudantang. Compared with the normal group， the modeling up-regulated the mRNA levels of HMGB1， RAGE， IKK， IκBα， and NF-κB （P<0.05）. Compared with the model group， Dahuang Mudantang and octreotide down-regulated the mRNA levels of HMGB1， RAGE， IKK， IκBα， and NF-κB （P<0.05）， and the high-dose Dahuang Mudantang demonstrated the best performance （P<0.05）. Western blot results showed a trend consistent with the results of Real-time PCR. ConclusionDahuang Mudantang can improved the general status， reduce inflammation， and alleviate histopathological changes in the pancreatic and colon tissues in the rat model of acute pancreatitis by inhibiting the HMGB1/RAGE/NF-κB signaling pathway.

Development of dose verification methods for boron neutron capture therapy / 中华放射医学与防护杂志

To summarize the progress in BNCT dose verification method in the world and discusses their development prospects. Boron neutron capture therapy (BNCT) utilizes the specific capture reaction between the neutrons and boron drugs enriched in tumor cells to selectively kill tumor cells. In order to verify the accuracy of the radiotherapy plan and ensure the therapeutic effect on patients, it is necessary to measure the dose before treatment and compare the experimental radiation dose with the planned dose. The current BNCT dose measurement method mainly include point dose measurement method based on ionization chambers, thermoluminescence dosimeters and activation foils, two-dimensional dose measurement method based on films, and three-dimensional dose measurement method based on gel dosimeters.

Mechanism of Dahuang Mudantang in Improving Pancreatic Injury in Rats with Acute Pancreatitis of Dampness-heat in Large Intestine Syndrome Based on Network Pharmacology and Experimental Verification / 中国实验方剂学杂志

ObjectiveTo reveal the intervention effect of Dahuang Mudantang on pancreatic injury in rats with acute pancreatitis （AP） of dampness-heat in large intestine syndrome and explore its possible mechanism based on network pharmacology. MethodNinety-six SPF-grade Wistar rats were randomly divided into the following six groups： a blank group， a model group， low-， medium-， and high-dose Dahuang Mudantang groups （3.5， 7， and 14 g·kg-1）， and a Qingyi Lidan granules group （3 g·kg-1）， with 16 rats in each group. The AP model of dampness-heat in large intestine syndrome was induced in rats except for those in the blank group by "high-temperature and high-humidity environment + high-sugar and high-fat diet + retrograde injection of 5% sodium taurocholate into the pancreaticobiliary duct". The blank and model groups received equal volumes of distilled water by gavage， while the treatment groups were administered Dahuang Mudantang or Qingyi Lidan granules 1 hour before modeling， and 12 and 24 hours after modeling. Samples were collected 1 hour after the last administration. The general conditions of the rats were observed. The AP model of dampness-heat in large intestine syndrome was evaluated. Serum amylase （AMS） and C-reactive protein （CRP） levels were determined using biochemical methods. Pancreatic tissue morphology was observed using hematoxylin-eosin （HE） staining. Network pharmacology was employed to predict potential targets of Dahuang Mudantang in the intervention in AP， and molecular biology technique was used to verify relevant targets. ResultCompared with the blank group， the model group exhibited lethargy， unkempt fur， loose and foul-smelling stools， elevated anal temperature with arching and twisting reactions， significantly increased serum levels of AMS and CRP （P<0.05）， abnormal pancreatic ductules， disordered interlobular spaces， and inflammatory cell infiltration in histopathological examination， as well as pathological changes including pancreatic acinar cell swelling， congestion， and necrosis. Compared with the model group， the treatment groups showed varying degrees of improvement in general survival conditions， reduced twisting reactions， visibly improved stool characteristics， reduced pancreatic tissue edema and necrosis， decreased serum AMS and CRP levels （P<0.05）， with the high-dose Dahuang Mudantang group showing the most pronounced effects （P<0.05）. Network pharmacology prediction indicated that hederagenin， β-sitosterol， and quercetin were the most widely connected active compounds with disease targets. Protein-protein interaction （PPI） network analysis revealed that protein kinase B （Akt）， tumor protein P53 （TP53）， tumor necrosis factor （TNF）， interleukin-6 （IL-6）， transcription factor （JUN）， vascular endothelial growth factor α （VEGFα）， interleukin-1β （IL-1β）， and vascular cell adhesion molecule-1 （VCAM1） were key targets in the "drug-disease" interaction. KEGG enrichment analysis suggested that the response of the mitogen activated protein kinase （MAPK） signaling pathway might be a core mechanism for DHMDT in the intervention in AP. Molecular biology analysis showed that compared with the blank group， the model group had significantly increased levels of TNF-α， IL-6， and VCAM-1 in pancreatic tissue （P<0.05）， as well as significantly elevated expression levels of p38 mitogen-activated protein kinase （p38 MAPK）， mitogen-activated protein kinase-activated protein kinase 2 （MK2）， and human antigen R （HUR） genes and proteins （P<0.05）. Compared with the model group， the treatment groups exhibited decreased levels of TNF-α， IL-6， and VCAM-1 in pancreatic tissue （P<0.05）， reduced expression levels of p38 MAPK， MK2， and HUR genes and proteins， with the high-dose Dahuang Mudantang group showing the most pronounced effects （P<0.05）. ConclusionDahuang Mudantang activates and regulates the p38 MAPK/MK2/HUR signaling pathway to suppress the release of inflammatory factors， thereby improving pancreatic injury.

Efficacy and Safety of KRASG12C Inhibitors in Advanced Solid Tumors with KRASG12C-mutated: A Single-arm Meta-analysis / 肿瘤防治研究

Objective To systematically study the efficacy and safety of KRASG12C inhibitors in advanced solid tumors with KRASG12C-mutated. Methods Computer searches from PubMed, The Cochrane Library, Web of Science, Embase, CNKI, and CBM databases were conducted to collect clinical studies on KRASG12C inhibitors in advanced solid tumors with KRASG12C-mutated, with a search time from inception to October 12, 2022. Then, two investigators independently screened the literature, extracted information, assessed the risk of bias in included studies, and performed meta-analyses using RevMan 5.4 software. Results There were four publications included, all of which were single-arm clinical studies. The KRASG12C inhibitors that completed clinical phase Ⅰ and Ⅱ trials were sotorasib and adagrasib, with two publications each. A total of 388 and 394 patients were included in the efficacy evaluation and safety evaluation, respectively. Resultsof the Meta-analysis showed that the patients had objective response rate, overall disease control, and disease stabilization rates of 35%, 82%, and 45%, respectively. In addition, the rate of serious adverse events, general adverse events, and all adverse events in patients was 2%, 28%, and 79%, respectively. Moreover, the rate of partial remission of disease in NSCLC patients was 38%. Conclusion The KRASG12C inhibitors sotorasib and adagrasib exhibited good efficacy and high safety in advanced solid tumors.

Recanalization for symptomatic chronic internal carotid artery occlusion: a preliminary study / 中华放射学杂志

Objective:To evaluate the value of endovascular recanalization and hybrid recanalization for chronic internal carotid artery occlusion(COICA), and to evaluate its feasibility, safety, success rate, and clinical outcomes.Methods:Totally 35 patients who received endovascular recanalization or hybrid recanalization with symptomatic COICA were enrolled from January 2019 to December 2019 in Department of Cerebrovascular Disease,Zhengzhou University People′s Hospital. The clinical characteristics, treatment strategies, success rate, and major events of the patients were analyzed retrospectively.Results:Thirty of 35 patients were successfully recanalized. Among them, hybrid recanalization was performed in 3 cases, carotid endarterectomy was performed in 1 case, and endovascular recanalization was performed in 26 cases, 5 patients failed because they could not reach the distal true cavity. Among the successful patients, 5 patients had operation-related complications, 3 patients had embolism cerebral infarction, 1 patient had hyperperfusion cerebral hemorrhage, 1 patient still had transient ischemic attack after operation. All patients were followed up clinically, 2 patients had reoccurrence of obstruction, 2 patient had restenosis, the remaining patients had no hemodynamic stenosis or reocclusion.Conclusion:In highly-selected cases, intracavitary recanalization for symptomatic COICA is feasible, relatively safe and effective.

The clinical diagnosis and treatment strategy of lumbar brucellar spondylitis / 中华骨科杂志

Lumbar brucellar spondylitis is an infectious disease caused by the invasion of brucella. The incidence has been on the rise in recent years. And it threatens people's health seriously. Early and proper diagnosis and treatment is the key to cure patients with lumbar brucella spondylitis. However, in the early stage of the disease, there are only nonspecific symptoms such as back pain, fever, and sweating. If the patient has the above symptoms and epidemiological history of direct or indirect livestock contact, and inflammatory signals of the vertebrae or intervertebral space are visible on MRI, the possibility of early infection of lumbar brucella spondylitis should be considered. It is not difficult to make the diagnosis of lumbar brucella spondylitis in the middle and late stages by taking into account the epidemiology, symptoms, signs, laboratory tests, and the imaging features such as narrowing of the intervertebral space, abnormal signals of the vertebral body and disc, bone destruction and sclerosis, "lace-like" appearance, sequestrum formation and limited paraspinal abscess. Patients in these stages often present with serious manifestations such as lumbar instability due to bone destruction, and the focus is on surgical intervention. The basic principle of surgical treatment is lesion removal combined with fixation. Intraoperative reduction of damage to bone and ligamentous structures such as the posterior ligamentous complex and strong fixation will contribute to the complete cure of the disease. By referring to the literature on lumbar brucellar spondylitis, this paper focuses on the etiology, pathogenesis, clinical manifestations, imaging features, laboratory tests and conservative and surgical treatment of the disease, aiming to provide a basis for clinical diagnosis and treatment.

Study on the relationship between 25-hydroxyl vitamin D deficiency and food allergy in children with atopic dermatitis / 重庆医学

Objective The purpose of this study was to detect serum 25-hydroxyvitamin D [25-(OH) VitD] levels in children with atopic dermatitis (AD) and to explore its association with food allergy (FA).Methods Sixty cases of infant patients with AD have been collected.The morning fasting venous blood were obtained to check the 25-(OH)VitD level in serum.Moreover,IgE in 6 kinds of common food was also tested.Multiple regression analysis was used to analyze the relation between 25-(OH)VitD level in serum and FA.The potential risks and confounding factors were adjusted.Results Among the 60 AD children,67.4％ of them had FA,and the majority of them had milk allergy (86.84％),no wheat allergy was found.There was a positive correlation between 25-(OH) VitD levels and age (r=0.46,P＜ 0.01),but no statistical correlation with total IgE levels (P＞0.05).25-(OH)VitD deficiency may significantly increase the risk of suffering from FA (OR=11.20,95％CI:1.35-73.66,P=0.023).Conclusion The decrease of the 25-(OH)VitD level in infant patients with AD is associated with FA.What's more,25-(OH)VitD deficiency may be a risk factor for increasing FA.

Treatment of posterior longitudinal ligament ossification of thoracic spine with posterior transforaminal spinal decompression / 中华骨科杂志

Objective To explore the safety,efficacy and outcomes of posterior transforaminal spinal cord reduction in the treatment of severe thoracic ossification of the posterior longitudinal ligament.Methods Since May 2010 to May 2016,21 patients with thoracic spinal stenosis with ossification of the posterior longitudinal ligament and embedding rate of more than 50％ underwent posterior circular decompression,12 males and 9 females;age 42-71 years old,with an average of 63.3±1.6 years old.There were severe spinal cord compression symptoms before surgery.The operation was from the posterior median approach.First,the pedicle screw tract was preset in the upper and lower segments where decompression was required,and then the posterior wall of the spinal canal was removed by the "uncovering method" to complete the posterior decompression.Through the superior and inferior articular joints,the joints were removed,the intercostal nerves were pushed outward,the extracorporeal intervertebral space and intervertebral disc tissue were revealed,and the vertebral cancellous bone of the lower vertebral body was removed.Separate the adhesion of the dura mater,use the special tool to cut the upper and lower edges of the posterior longitudinal ligament,collapse,remove the posterior longitudinal ligament ossification block,and complete the decompression of the front of the spinal cord through one or both sides.Finally,the pedicle screw fixation and the intervertebral bone graft were completed.Postoperative follow-up (mean 38.5 months) CT and MRI scans were performed to observe the patency of the spinal canal and the state of the internal fixation.The Frankel graded evaluation function was restored,the JOA score was used to evaluate the neurological function,the Otani evaluation system was used to evaluate the surgical outcome,the clinical excellent rate was calculated,and the treatment effect was evaluated.Results Nineteen cases recovered after operation,and 1 case showed a transient decrease in unilateral lower extremity motor function on the second day after surgery.It returned to normal after dehydration and neurotrophic support treatment,and 1 case had bilateral lower limbs on the day after surgery.Muscle strength was transiently lost,feeling recovered after 6 hours,and exercise resumed after 48 hours.The operation time was 180-300 min,with an average of 240±23 min.The intraoperative blood loss was 168±12 ml.Postoperative spinal cord function recovered significantly.At the last follow-up,Frankel graded F in 8 cases and grade E in 13 cases.Preoperative average JOA score was 3.5,and the JOA score of the follow-up was increased from 3.5±0.98 points to 9.0±0.9 points.The improvement rate of JOA score was excellent in 14 cases,good in 5 cases,and fair in 2 cases.According to Otani system there was excellent in 14 cases,good in 6 cases,and fair in 1 case.The excellent and good rate was 95.24％.Cerebrospinal fluid leakage occurred in 3 cases and healed after symptomatic treatment.No chest occurred during the follow-up period.The vertebral instability,internal fixation loose,broken.Conclusion Posterior transforaminal spinal decompression of posterior longitudinal ligament ossification of thoracic spine can be finished using self-developed special surgical tools,which is safe,effective and can achieve full decompression of spinal cord.

The Construction of Provincial Regional Medical Collaboration Based on Cloud Computing Model / 医学信息学杂志

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

Cervical expensive open-door laminoplasty combined with vitamin B12 treatment for patients of cervical spondylotic myelopathy with subacute combined degeneration of the spinal cord / 中华骨科杂志

Objective To investigate the clinical outcome of cervical expensive open-door laminoplasty combined with vitamin B12 treatment for patients of cervical spondylotic myelopathy with subacute combined degeneration of the spinal cord.Methods Data of 10 patients with cervical spondylotic myelopathy with subacute combined degeneration of the spinal cord in February 2013 to August 2013 were retrospectively analyzed.There were 7 males and 3 females with an average age of 46 years (range,32-73 years).Eight patients' history was in six months,and others' was beyond six months.All patients had undergone cervical expansive open-door laminoplasty with mini-plate fixation combined with intramuscular injection or pre os vitamin B 12.Patient imaging data were used to assess the stability of the cervical spine,and spinal cord compression in the fixed position before and after their surgery.Japanese Orthopaedic Association (JOA) score was used to evaluate function,and the rate of neurological improvement was calculated.The American Spinal Injury Association was used to evaluate the neurological function inpatients before and after surgery.The preoperative and postoperative numerical changes of SEP and vitamin B 12 were compared using correlation analysis.Each dimension of preoperative and postoperative scores change was compared by Life quality evaluation F-36 scale.Results All patients were followed up for an average period of 15 months (range,6-26 months).There were no complications related to the internal fixation,such as fixation loosened or broken.Cerebrospinal fluid surrounding the spinal cord within the C3-7 range of the signal on MRI T2WI of the continuous had been recovered.JOA score increased from preoperative 9.6±2.04 to postoperative 14.7±2.04,and postoperative neurological improvement rate was 20％-80％.The excellent and good rate was 90％ (9/10) including 4 excellent and 5 good.Vitamin B12 level before operation:78.30±42.82 pg/ml,postoperative:176.50±85.77 pg/ml.Electromyography and SEP had been all recovered.There was correlation between preoperative and postoperative vitamin B 12 levels with spinal cord function score.According to ASIA score,there were 4 cases in C level,6 in D level preoperatively,while 2 in C level,5 in D level,3 in E level postoperatively.Conclusion Cervical spondylotic myelopathy with subacute combined degeneration of the spinal cord could be treated by surgery.Vitamin B 12 by per os or intramuscular injection with removal of the cervical spinal cord compression which creates a space for recovery of spinal cord could improve the surgical curative effect.

The application of indwelling guide-wire technique in performing mechanical thrombectomy for acute cerebral artery occlusion / 介入放射学杂志

Objective To discuss the application value,safety and feasibility of indwelling guidewire technique in performing mechanical thrombectomy for acute cerebral artery occlusion.Methods The clinical data of 15 patients with acute ischemic stroke,who were treated with mechanical thromnectomy at authors' hospital during the period from December 2015 to February 2016,were retrospectively analyzed.The diseases included middle cerebral artery occlusion (n=6),internal carotid artery and middle cerebral artery occlusion (n=5) and vertebral basilar artery occlusion (n=4).Indwelling guide-wire technique was adopted to quickly and accurately determine the vascular occlusion characteristics,then,endovascular mechanical thrombectomy was carried out.Results By using indwelling guide-wire technique,the occlusive features of the diseased arteries were successfully and precisely determined.Immediate recanalization of the occluded artery was obtained in 13 patients (87％).The blood flow classification score after thrombolysis in cerebral infarction (TICI) reached 3 points in 10 patients and 2b points in 5 patients.In 2 patients,the vascular recanalization procedure failed because the thrombus load was large,the length of occluded segment was long,and the effect of mechanical thromnectomy was poor.According to American National Institutes of Health Stroke Scale (NIHSS),the evaluation score was improved from preoperative (19.2±7.0) to postoperative (6.3±3.6),the difference was statistically significant (P＜0.05).Three months after the treatment,the score measured by modified Rankin scale(mRS) was ≤2 points in 10 patients.Conclusion Mechanical thrombectomy is safe and effective for the treatment of acute cerebral artery occlusion.The indwelling guide-wire technique can safely,conveniently,quickly and accurately determine the characteristics of the occluded blood vessels,which is very helpful in assisting surgical manipulation,reducing procedure-related complications,and improving vascular recanalization rate.(J Intervent Radiol,2017,26:202-205)

Comparison of the effects of different fixation methods on open-door side in posterior expansive open-door laminoplasty / 中华骨科杂志

Objective To investigate the clinical outcome and complications of different types of expansive open door laminoplasty in cervical spondylotic myelopathy.Methods From December 2008 to June 2012,221 patients with cervical spondylotic myelopathy treated with expansive open-door laminoplasty were divided into micro-titanium plate fixed group (96 cases),wire hanging fixed group(66 cases),anchor suspension fixed group (59 cases).The clinical outcome was evaluated including JOA score,operation time,bleeding volume,spinal cord pressure (a/M),cervical range of motion (ROM),open door angle,posterior shift distance of spinal cord and postoperative complications.Results All patients were followed up for more than 2 years.There were no significant differences in general condition,operation time,intraoperative blood loss,preoperative and postoperative 2 years JOA score,JOA score improvement rate,spinal cord shift distance,spinal cord compression among three groups;In the incidence of C5 nerve root paralysis,there was no significant difference between the silk suspension fixation group (12.1％) and the anchored suspension group (11.9％).The incidence of C5 nerve root paralysis for microplate fixation group (2.1％) was significantly lower than that of the silk suspension fixation group and anchored suspension fixation group,and the difference was statistically significant.There was no significant difference in the fusion rate between the 3-month and 6-month portal arteries in the group of silk suspension fixation group(65％,82％) and anchor fixation group(61％,82％).The fusion rate of the microtiter plate fixation group(90％,98％) was significantly higher than that of the silk suspension group and the anchorage group at 3 months and 6 months after operation.There were no significant differences in the incidence of recurrence,the total amount of cervical spine loss and the incidence of axial symptoms after 6 months of operation in the suspension group and the anchor suspension group.The incidence of occlusion,the total amount of cervical spine loss and the incidence of axial symptoms were significantly lower in the micro titanium plate fixation group than those in the silk suspension group and the anchorage fixation group,the difference was statistically significant.Conclusion Using micro-titanium plate to fix the side of open door could achieve full spinal cord decompression and access to satisfactory neurological improvement rate.At the same time,compared with the traditional silk or anchor suspension,the use of micro-titanium plate is more conducive to the door axis bone healing,prevent the occurrence of reclosing,significantly reduce the loss of postoperative cervical range of motion,and reduce the incidence of axial symptoms with the satisfaction of the clinical outcome.

"Research on the ""Healthy Henan Health Service Cloud"" Platform Based on Cloud Computing" / 医学信息学杂志

The paper elaborates on the construction concept ofHealthy Henan Health Service Cloud and introduces the project goals and system architecture.This platform effectively promotes the application and popularization of achievements in health informatization in Henan,enables the basic mass to experience the efficiency and convenience brought about by health informatization,and facilitates the monitoring and management by health administrative departments.

Extended to C1, 2 spinal posterior cervical open-door expansion of the angioplasty treatment combined with cervical spinal stenosis / 中华骨科杂志

Objective To explore the surgical method and effects of posterior expansive open-door laminoplasty extended to C1,2 levels.Methods 16 cervical spinal stenosis patients with cervical myelopathy were posterior cervical surgery in our hospital from February 2013 to September 2015,including 11 males and 5 females;aged 51-76,average 62.8.4 cases merged C1spinal stenosis,the line which operated by C1～7 spinal posterior open-door expansion of the forming with mini titanium fixation;12 cases merged C2 spinal stenosis,which had the operation of C2～7 posterior open-door laminoplasty with Micro Titanium fixation plate.According to the patient imaging data to assess the stability of the cervical spine,and spinal cord compression fixation position before and after their surgery evaluated;the preoperative and postoperative pain using visual analog scale (VAS);application Japanese Orthopaedic Association (JOA) score spinal cord score was used to evaluated spinal cord function,and calculates the rate of improvement of neurological function;surgery patients before and after application Frankel grading was used to evaluate neurological function.Results All patients were followed up,for an average of 11.58 months (2-33 months).16 patients showed no loosening,fracture fixation and related complications,C1,2 showed no instability;cerebrospinal fluid surrounding the spinal cord with in the C1-7 range of the signal on MRI T2WI showed continuous recovery;preoperative VAS score was 6.7 points,postoperative VAS score was 1.8 points;the first 16 cases of patients with preoperative JOA score average (8.3± 1.6) points,postoperative JOA score was (14.6±1.4) points,postoperative neurological improvement rate was 91.6％;Frankel grade C before operation and grade E in postoperation;postoperative follow-up neurological improvement rate excellent 7 cases,good 7 cases,general 2 cases.Conclusion Treatment of cervical spinal stenosis combined with cervical myelopathy may use a C 1-7 posterior spinal expand within the single door molding fixation with mini titanium plate,which can release the compression of the cervical spinal cord nerve and reconstruct a stable structure of posterior of cervical spine.

The feasibility and efficacy of transradial approach for carotid artery stenting using 6 F guiding catheter / 中华放射学杂志

Objective To explore the feasibility and safety of using 6 F guiding catheter to perform the carotid artery stenting (CAS) via transradial approach (TRA). Methods A retrospective analysis of 28 cases with carotid atherosclerotic stenosis who were using 6 F guiding catheter to perform the CAS via TRA, and the preoperative assessment confirmed that some of whom were difficult to operate via femoral artery, or couldn't tolerate the lying in bed after the operation, and the others were failure to perform via femoral artery. The atherosclerotic carotid stenosis lesion of 9 cases were located in the left internal carotid artery (ICA), and the other 19 cases were in the right ICA. All the patients were performed via the right radial artery approach, a 6 F guiding catheter was used to super-select the target vessel, implanted the distal protection device, then underwent balloon angioplasty and stent implantation. We observed and recorded that whether the guiding catheters were in the right places, the success rate of stent implantation, the incidence of radial artery spasm and the puncture site bleeding. The postoperative pulse and occlusion of radial artery, and the occurrence of cardio-cerebrovascular complications during perioperative period were also observed. The fluoroscopy time of surgery ray were also recorded, and compared with corresponding 30 cases who were performed CAS via the tranfemoral approach (TFA) by t test. Results The guiding catheters were in the right places and stenting success of all the 28 cases. There was no significant difference in the fluoroscopy time between TRA and TFA group [(8.6 ± 1.4) min vs. (9.0 ± 2.1) min,t=-0.717,P=0.477)]. Two cases appeared radial artery spasm after puncture, and 1 case experienced puncture site bleeding at 8 h after the operation. After examined the radial artery by color doppler ultrasound at 1 week after the operation, we found that blood flow of 27 cases were patency, but another 1 was slowed down, which was restored at 3 months follow up. None of the cases occurred cerebrovascular events in the present research. Conclusion Transradial approach for CAS using 6 F guiding catheter is safe and technically feasible.

Developing the questionnaire on the causes of aggressive behavior in patients with schizophrenia: nurses' attitudes / 中国实用护理杂志

Objective To develop a questionnaire suitable for China's cultural background on nurses' attitudes towards the causes of aggressive behavior in patients with schizophrenia,and to test its reliability and validity.Methods By literature review,semi-structured interview and combining with the China's conditions,the draft of the questionnaire item pool was formed,which was evaluated by the experts.Then the reliability and validity of the questionnaire were tested by investigating 340 nurses.Results The effective questionnaires were 312 copies.The questionnaire included 4 dimensions and 29 items.Exploratory factor analysis extracted 4 factors,the total explained variance was 56.175％.The Cronbach alpha coefficient of the questionnaire was 0.909,and the dimensions' Cronbach alpha coefficient was 0.812-0.896.The testretest reliability of the questionnaire was 0.897,and the dimensions' test-retest reliability was 0.742-0.886.The average of total questionnaire's content validity index was 0.968 and the average of the dimensions'content validity index was 0.943-0.978.Conclusions The questionnaire has good reliability and validity,which can be used to investigate nurses' attitudes towards the reasons of the aggressive behavior in patients with schizophrenia.

Relations of the doctor-patient with psychological security and stress in operation patients / 中国实用护理杂志

Objective To explore the relations of the doctor-patient relationship to psychological security and stress.Methods Totally 430 operation patients were selected and followed-up.A survey was performed using the Security Questionnaire (SQ),the Patient Doctor Relationship Questionnaire 13-Item Version (PDRQ-13),the Hospital Stress Rating Scale (HSRS) Results The average score of SQ was lower than medium value in operation patients.The SQ scores of operation patients with emergency operation were 39.50±10.51,lower than those of selective operation which were 49.02±10.37 and limited operation which were 47.67±10.29 (P ＜ 0.05).The SQ scores of operation patients who didn't provided themselves were 37.33±10.10,lower than those of basically which were 40.10±10.83 and partly provided for themselves which were 43.50±10.51 (P＜ 0.05).The SQ scores of operation patients in severe group according severity of illness were 37.13±10.40,lower than those of them in mild group which were 39.19±10.24 and moderate group which were 41.38±10.01 (P＜ 0.01).The SQ scores of post-operation patients were 44.32±9.96,higher than post-operation patients which were 40.36±10.81 (P ＜ 0.01).The lack of comforts (LC),lack of information (LI) and risks of serious disease (RSD) scores of post-operation patients were 49.23±30.62,30.46±21.42,52.84±31.22,lower than those of post-operation patients which were 52.37±32.06,35.25±20.14,80.12±33.18 (P ＜ 0.05).The path analysis showed that the regression relationship between SQ scores and PDRQ scores,RSD scores was established (β=0.40,-0.26,P ＜ 0.01),and the PDRQ-13 scores was a mediator between the scores of LC,LI,RSD and the SQ scores (β=0.40,P＜0.01).The PDRQ-13 scores was a adjustor between the RSD scores and the SQ scores (β=-0.34,P ＜ 0.01).Conclusions The operation patients have a low level of the sense of security which is statistically significant with surgical types,the ability to care for themselves and severity of illness.The sense of security of post-operation patients were higher than those of pre-operation patients.The recognition of physician-patient relationship may be play a mediating and adjusting role between the sense of security and stress.The surgical stress affect patient security and physician-patient relationship.

Comparison of the perioperative complications among three prophylactic antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling / 中华放射学杂志

Objective To compare the perioperative complications of prophylactic use of three antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling. Methods A total of 203 consecutive patients were brought into this retrospective study including the following three groups:the loading group (n=54), with a loading dose of 300 mg to 600 mg clopidogrel at 2 h to 24h before the stenting; tirofiban group (n=50), a loading dosage of tirofiban (8 μg/kg/min over 3 min) followed by a 0.1μg/kg/min maintenance dosage; dual antiplatelet group (n=99), dual oral antiplatelet drugs (clopidogrel 75 mg + aspirin 100 mg) pretreated for 3-5 days before the operation. Events of hemorrhage and thromboembolism were recorded and the complications were compared to assess the safety and efficacy of various antiplatelet strategies. Chi-square or Fisher exact tests were used for categorical variables. Results The hemorrhagic rates were 11.1% in loading group, 2.0% in dual antiplatelet group, and 0% in tirofiban group, respectively, while the thromboembolic rates were 7.4% in loading group, 4.0% in dual antiplatelet group, and 0% in tirofiban group, respectively. For total complications, significant difference (P0.05). The hemorrhagic rate in loading group was significantly higher than that of the dual group (P=0.023) and tirofiban group (P=0.027), while there was no significant difference between tirofiban group and dual antiplatelet group (P>0.05). In subgroup analysis of the loading group, the postoperative thromboembolic rate was significantly higher in those exposed to low molecular weight heparin than those not (P=0.039) with no increase of hemorrhagic events (P>0.05). Conclusions When compared with the dual antiplatelet strategy, tirofiban strategy may be used as a new prophylactic protocol in unruptured intracranial aneurysms treated by stent assisted coiling. Those treated by low molecular weight heparin postoperatively after receiving dual antiplatelet therapy may increase the hemorrhagic risk, although there was a significant decrease in thromboembolic events postoperatively.

Clinical Observation of Biyuan Tongqiao Granule Combined with Triamcinolone Acetonide Spray in the Treatment of Chronic Rhinosinusitis / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Biyuan tongqiao granule combined with Triamcinolone acetonide spray in the treatment of chronic rhinosinusitis. METHODS:120 patients with chronic rhinosinusitis were randomly divid-ed into observation group and control group,with 60 cases in each group. Control group was given Triamcinolone acetonide spray 220 μg,qd,in first week,decreasing to 110 μg,qd;observation group was additionally given Biyuan tongqiao granule 15 g,tid, on the basis of control group. Both groups were treated continuously for 10 weeks. The clinical efficacy of 2 groups were observed as well as the levels of MTR,IL-5 and IL-8,SNOT-20 score,VAS score and Lund-Mackey sinus CT score before and after treat-ment. The incidence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 93.3%, which was significantly higher 85.0% of control group,with statistical significance(P0.05). IL-5 and IL-8 levels of 2 groups decreased significantly,while MTR,SNOT-20 score,VAS score and Lund-Mackey sinus CT score were decreased significantly;the observation group was better than the control group,with statistical significance(P0.05). CONCLUSIONS:Biyuan tongqiao gran-ule combined with Triamcinolone acetonide spray is effective in the treatment of chronic rhinosinusitis,and can effectively improve the quality of life and relieve clinical symptom with good safety.

Independent research and development of hepatitis B five internal quality control products by the detection of ELISA / 国际检验医学杂志

Objective To use ELISA detecting self‐developed hepatitis B five internal quality control products .Methods Hepa‐titis B five positive sera by the detection of ELISA were diluted through optimal ratio ,and were homemade indoor quality control materials .Results Self‐control materials and commodities were simultaneously detected by ELISA ,and the test results were com‐pared ,the two were no significant difference(P>0 .05);Self‐control materials continuously detected by ELISA ,its batch variation were less than 15% ,and stability was in line with the requirements .Conclusion Self‐developed hepatitis B five indoor quality con‐trol materials are made simply ,have good stability ,are satisfied control effect ,and have promotional value .