Safety of modified T-piece resuscitator versus nasal cannula oxygen in electronic bronchoscopy for infants: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy.@*METHODS@#A prospective randomized, controlled, and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021. These infants were divided into a nasal cannula (NC) group and a modified T-piece resuscitator (TPR) group using a random number table. The lowest intraoperative blood oxygen saturation was recorded as the primary outcome, and intraoperative heart rate and respiratory results were recorded as the secondary outcomes.@*RESULTS@#Compared with the NC group, the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia (P<0.05). In the modified TPR group, there were 6 infants with mild hypoxemia, 2 with moderate hypoxemia, and 1 with severe hypoxemia, while in the NC group, there were 3 infants with mild hypoxemia, 5 with moderate hypoxemia, and 9 with severe hypoxemia (P<0.05). The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group (P<0.05), but there was no significant difference in the incidence rate of arrhythmias between the two groups (P>0.05).@*CONCLUSIONS@#Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy, and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.

Morphological examination and integrated diagnosis of hematologic diseases / 中华检验医学杂志

The morphologic examination of hematologic diseases, mainly by bone marrow smear and/or blood smear needs to keep pace with the times. Several morphological methods need to be optimized and complemented. The joint examination of bone marrow smear, blood smear, bone marrow biopsy imprint and bone marrow section is a relatively complete integrated mode. Together with the meaningful new morphological test items, the reliable diagnosis of morphology can be significantly improved. At the same time, it is also necessary to expand and deepen the diagnostic thinking, integrate clinical, immunophenotype and genetic thinking, and take diagnostic evidence and rules as the criterion, which was the main theme of modern morphological inspection and diagnosis.

Differences in chemical components in processing of dried ginger-steamed, sand-fried, and rice swill water-bleached Aconiti Lateralis Radix Praeparata pieces in "Jianchang" faction based on UPLC-MS/MS / 中国中药杂志

This study compared the changes in chemical components during the processing of different types of Aconiti Lateralis Radix Praeparata(ALRP) in "Jianchang" faction, i.e., dried ginger-steamed ALRP pieces(Yin-FP), sand-fried ALRP pieces(Yang-FP), and rice swill water-bleached ALRP pieces(DFP), and provided a scientific basis for the mechanism in toxicity reduction and efficacy enhancement from a compositional perspective. Samples were collected during the processing of the three types of ALRP pieces, yielding raw ALRP pieces, water-bleached Yin-FP, ginger juice-moistened Yin-FP, steamed Yin-FP, water-bleached Yang-FP, sand-fried Yang-FP, water-bleached DFP, rice swill water-bleached DFP, and roasted DFP. Aconitine, mesaconitine, hypaconitine, benzoylaconine, benzoylmesaconine, benzoylhypaconine, aconine, mesaconine, hypaconine, salsolinol, fuziline, and higenamine in the extracts were determined by UPLC-MS/MS, and then content analysis and cluster heatmap analysis were performed on 11 sets of samples. During the processing of the three types of ALRP pieces, bleaching significantly reduced the content of 12 alkaloids; steaming, stir-frying, and roasting significantly reduced the content of diester-type alkaloids(aconitine, mesaconitine, and hypaconitine) and significantly increased the content of monoester-type alkaloids(benzoylaconine, benzoylmesaconine, and benzoylhypaconine) and aminoalcohol-type alkaloids(aconine, mesaconine, and hypaconine). During the processing of Yin-FP, the diester-type alkaloids continuously decreased, while the monoester-type and aminoalcohol-type alkaloids showed an initial decrease followed by an increase. During the processing of Yin-FP, Yang-FP, and DFP, the diester-type alkaloids continuously decreased, while the monoester-type and aminoalcohol-type alkaloids showed an initial decrease followed by an increase. Steamed Yin-FP showed a higher increase in content than fried Yang-FP and roasted DFP. Comprehensive analysis of content differences in toxic and therapeutic components in three ALRP pieces suggests that the distinctive processing methods in "Jianchang" faction can indeed achieve detoxification and efficacy enhancement on ALRP. This study provides references for understanding the mechanisms of action of the three processing methods.

Oblique supine one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection in the treatment of 24 cases of upper urinary tract uroepithelial carcinoma / 现代泌尿外科杂志

【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.

Research progress on "sandwich" osteotomy to increase alveolar bone / 口腔疾病防治

@#Lack of alveolar bone height is a major challenge for dental implants. In recent years, the use of "sandwich" osteotomy to increase alveolar bone height has become a topic of discussion within the research community. In theory, "sandwich" osteotomy is a U-shaped osteotomy in the bone defect area, to preserve the blood supply of the mucoperiosteal on the lingual side and to create an artificial "four-wall bone bag" to build a favorable space for osteogenesis and to increase the height of the alveolar bone. Histological studies have shown that the osteogenesis speed of "sandwich" osteotomy is fast, and the bone is good. Sandwich osteotomy is suitable for buccal-lingual alveolar bone height defects less than 50% of the implant length or for unilateral defects more than 50% of the implant length. In the operation of "sandwich" osteotomy, the horizonal incision should be 10-12 mm below the crest of the buccal alveolar ridge. The design of the osteotomy line should ensure the height of the osteotomy block and that the mandibular canal does not sustain damage and that it fits the shape of the bone defect. There was no significant difference in the osteogenic effect of different types of bone graft materials used for "sandwich" osteotomy. The osteotomy block was rigorously fixed by a titanium plate, titanium nail, implant and other materials, and finally, the intraoperative area was tensioned and sutured. The effect of bone augmentation was evaluated and compared with other bone augmentation techniques; the evaluation showed that sandwich osteotomy was better for moderate vertical bone defects. This technique is highly sensitive and postoperative transient sensory loss is common. With advances in technology, the application of digital technology and ultrasonic bone knives, the risk of complications is greatly reduced and advances in digital osteotomy will promote apply of "sandwich" osteotomy, which will become a popularized technique for clinical alveolar bone augmentation.

Three-piece intraocular lens in the sulcus with optic capture in patients with mild to moderate zonular weakness in exfoliation

Purpose: To study the use of sulcus placement of a 3?piece intraocular lens (IOL) with optic capture in patients with exfoliation with zonular weakness. Methods: Data on all exfoliation patients who had direct or indirect evidence of zonular weakness and had a 3?piece IOL implanted in the sulcus with optic capture over a 5?year period between January 2017 and January 2022 were included in this retrospective case series. Results: The study comprised of 35 eyes of 35 patients. The mean age at surgery of the 20 male and 13 female patients was 75.21 years ± 5.74 (standard deviation (SD)). The mean pupillary diameter was 5.77 ± 2.23 mm (range: 10 to 3 mm). A capsular tension ring (CTR) was used in 17 cases and iris hooks as a pupil?expanding device were used in 15 cases. No patients had an increase in inflammation after surgery and there were no late subluxation or dislocation of “in the bag” posterior chamber IOL or major complications. There was a significant improvement in visual acuity. Conclusion: The sulcus placement of 3?piece IOL with optic capture is the ideal technique in patients with clinical or intraoperative evidence of mild to moderate zonular weakness. It may also be more appropriate in relatively younger patients (in the fifties or sixties) with exfoliation with no overt zonulopathy to prevent late subluxation or dislocation of “in the bag” IOL

Caracterización psicopedagógica del proceso de iniciación en ajedrez desde la perspectiva de los elementos básicos / Caracterização psicopedagógica do processo de iniciação ao xadrez a partir da perspectiva dos elementos básicos / Psycho-pedagogical characterization of the process of initiation in chess from the perspective of the basic elements

RESUMEN La investigación se dirigió hacia el proceso de iniciación deportiva del ajedrez durante el período de formación básica general, con el objetivo de caracterizar este proceso a partir de criterios psicopedagógicos durante la enseñanza-aprendizaje de los elementos básicos de esta disciplina deportiva; por tanto, su importancia radicó en la contribución a la didáctica especial del ajedrez, al imprimirle un carácter formativo, contextualizado y lógico secuencial en busca de la formación básica general de escolares desde un enfoque integral educativo. Además, desde la renovación teórica, se pueda concebir una iniciación deportiva de manera dialéctica y global para que capaciten al escolar y educador a adquirir recursos como conocimientos, habilidades y actitudes.

RESUMO A investigação foi orientada para o processo de iniciação desportiva no xadrez durante o período de treino básico geral, com o objectivo de caracterizar este processo com base em critérios psicopedagógicos durante o ensino-aprendizagem dos elementos básicos desta disciplina desportiva; portanto, a sua importância reside na contribuição para a didática especial do xadrez, dando-lhe um carácter formativo, contextualizado e sequencial lógico em busca da formação básica geral das crianças em idade escolar a partir de uma abordagem educacional integral. Além disso, a partir da renovação teórica, é possível conceber uma iniciação desportiva de forma dialética e global a fim de permitir aos alunos e educadores adquirirem recursos tais como conhecimentos, competências e atitudes.

ABSTRACT The research was directed towards the process of chess sports initiation during the period of general basic training, with the objective of characterizing this process from psycho-pedagogical criteria during the teaching-learning of the basic elements of this sport discipline; therefore, its importance lay in the contribution to the special didactics of chess, by giving it a formative, contextualized and logical sequential character in search of the general basic training of schoolchildren from an integral educational approach. In addition, from the theoretical renovation, it is possible to conceive a dialectic and global sport initiation in order to enable the schoolchildren and educator to acquire resources such as knowledge, skills and attitudes.

Ten-year experience with penile prosthetic surgery for the treatment of erectile dysfunction: outcomes of a tertiary referral center and predictors of early prosthetic infection / 亚洲男科学杂志(英文版)

We aimed to evaluate ten-year outcomes of penile prosthesis (PP) implantation for the treatment of erectile dysfunction and to assess predictors of early prosthetic infection (EPI). We identified 549 men who underwent 576 PP placements between 2008 and 2018. Univariate and multivariate analyses were used to identify potential predictors of EPI. An EPI predictive nomogram was developed. Thirty-five (6.1%) cases of EPI were recorded with an explant rate of 3.1%. In terms of satisfaction, 82.0% of the patients defined themselves as "satisfied," while partner's satisfaction was 88.3%. Diabetes (P = 0.012), longer operative time (P = 0.032), and reinterventions (P = 0.048) were associated with EPI risk, while postoperative ciprofloxacin was inversely associated with EPI (P = 0.014). Rifampin/gentamicin-coated 3-piece inflatable PP (r/g-c 3IPP) showed a higher EPI risk (P = 0.019). Multivariate analyses showed a two-fold higher risk of EPI in diabetic patients, redo surgeries, or when a r/g-c 3IPP was used (all P < 0.03). We showed that diabetes, longer operative time, and secondary surgeries were the risk factors for EPI. Postoperative ciprofloxacin was associated with a reduced risk of EPI, while r/g-c 3IPP had higher EPI rates without an increased risk of PP explant. After further validation, the proposed nomogram could be a useful tool for the preoperative counseling of PP implantation.

Effect of hemodiafiltration combined with Jinshuibao tablet on serum inflammatory factors in patients with diabetic nephropathy / 中国基层医药

Objective:To investigate the effect of hemodiafiltration combined with Jinshuibao tablet on serum inflammatory factors and oxidative stress indices in patients with diabetic nephropathy. Methods:A total of 86 patients with diabetic nephropathy who received treatment in The Second People's Hospital of Liaocheng from April 2019 to April 2020 were included in this study. They were randomly assigned to receive either hemodiafiltration (control group, n = 42) or hemodiafiltration combined with Jinshuibao tablet (observation group, n = 44). Microinflammatory state, oxidative stress index level, renal function and nutritional status were compared between the two groups. Results:Before treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in the control group were (30.13 ± 3.25) ng/L, (9.43 ± 2.57) mg/L, (46.69 ± 3.54) ng/L respectively, and they were (30.16 ± 3.34) ng/L, (9.48 ± 2.65) mg/L, (46.73 ± 3.38) ng/L respectively in the observation group. There were no significant differences in these indices between the two groups (all P > 0.05). After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in the control group were (16.69 ± 2.73) ng/L, (8.12 ± 2.21) mg/L, (35.63 ± 2.75) ng/L, respectively, and they were (12.34 ± 2.52) ng/L, (6.47 ± 1.53) mg/L, (26.65 ± 2.13) ng/L, respectively in the observation group. After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels in both groups were significantly lower than those before treatment (control group: t = 20.52, 2.50, 15.99; observation group: t = 27.60, 6.16, 32.57, all P < 0.05). After treatment, serum interleukin-6, high-sensitivity C-reactive protein and tumor necrosis factor-α levels were significantly lower than those in the control group ( t = 7.68, 4.04, 16.97, all P < 0.05). Before treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the control group were (5.63 ± 1.36) nmol/L, (63.38 ± 7.56) mU/L, and (195.96 ± 26.36) IU/L, respectively, while those in the observation group were (5.68 ± 1.25) nmol/L, (63.25 ± 7.38) mU/L, and (195.83 ± 26.27) IU/L, respectively. There were no significant differences in these indices between the two groups (all P > 0.05). After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the control group were (4.83 ± 1.13) nmol/L, (83.46 ± 5.75) mU/L and (236.69 ± 18.75) IU/L respectively, while those in the observation group were (4.24 ± 0.86) nmol/L, (88.75 ± 5.47) mU/L and (258.76 ± 15.47) IU/L, respectively. After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in each group were superior to those before treatment (control group: t = 2.93, 13.70, 8.16, P = 0.002, < 0.001, < 0.001; observation group: t = 6.15, 17.99, 13.37, all P < 0.001). After treatment, serum levels of malondialdehyde, superoxide dismutase, and glutathione peroxidase in the observation group were superior to those in the control group ( t = 2.73, 4.37, 5.96, P = 0.004, < 0.001, < 0.001). After treatment, blood urea nitrogen, serum creatinine and 24-hour urine protein in the observation group were significantly lower than those in the control group ( t = 7.85, 8.71, 2.06, P < 0.001, < 0.001, 0.021), and creatinine clearance rate in the observation group was significantly higher than that in the control group ( t = 3.01, P = 0.002). Total protein, prealbumin and albumin levels in the observation group were significantly higher than those in the control group ( t = 9.47, 12.13, 6.18, all P < 0.001). Conclusion:Hemodiafiltration combined with Jinshuibao tablet for the treatment of diabetic nephropathy has a positive effect on microinflammatory state and oxidative stress index level and improves patient's renal function and nutritional status.

Fijación de lentes intraoculares a esclera sin suturas / Sutureless scleral intraocular lens fixation

La corrección quirúrgica de la afaquia se realiza mediante varias técnicas que permiten fijar los lentes intraoculares en la cámara posterior, suturados al sulcus ciliar o por fijación transescleral de las hápticas sin suturas. El cirujano determina cuándo, dónde y cómo, además del tipo de lente a implantar. Se presenta un paciente con una afaquia traumática del ojo izquierdo, con agudeza visual sin corrección de cuenta dedos a un metro y refracción dinámica de +8,00 dioptrías con agudeza visual mejor corregida de 0,8 por cartilla de Snellen. Tensión ocular de 16 mmHg. En el examen biomicroscópico con lámpara de hendidura del ojo izquierdo se observó midriasis traumática. Se le realizó examen con biomicroscopia indirecta y resultó sin alteraciones. Se implantó el lente intraocular de tres piezas (Tecnis ZA9003) de la cámara posterior y se fijaron las hápticas a la esclera sin utilizar suturas. Al mes de la cirugía la agudeza visual mejor corregida fue la unidad de visión(AU)

Surgical aphakia correction is based on several techniques allowing to fix intraocular lenses in the posterior chamber, sutured to the ciliary sulcus or by sutureless transcleral fixation of the haptics. The surgeon will decide when, where and how, as well as the lens type to implant. A case is presented of a male patient with traumatic aphakia of his left eye, finger counting uncorrected visual acuity at one meter and dynamic refraction of +8.00 diopters with best corrected visual acuity of 0.8 by the Snellen chart. Ocular tension was 16 mmHg. Biomicroscopic slit lamp examination of the left eye found traumatic mydriasis. Indirect biomicroscopy did not find any alteration. A three-piece intraocular lens (Tecnis ZA9003) was implanted in the posterior chamber, fixing the haptics to the sclera without the use of sutures. One month after surgery, best corrected visual acuity was the vision unit(AU)

Comparison of the effects between low-level assisted ventilation and T-piece method on respiratory mechanics during weaning of mechanically ventilated patients / 中华危重病急救医学

Objective:To compare the difference of low-level assisted ventilation and T-piece method on respiratory mechanics of patients with invasive mechanical ventilation during spontaneous breathing trial (SBT) within 3 days before extubation.Methods:A retrospective observational study was conducted. Twenty-five patients with difficulty in weaning or delayed weaning from invasive mechanical ventilation who were admitted to department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from December 2018 to June 2020, and were in stable condition and entered the weaning stage after more than 72 hours of invasive mechanical ventilation were studied. A total of 119 cases of respiratory mechanical indexes were collected, which were divided into the low-level assisted ventilation group and the T-piece group according to the ventilator method and parameters used during the data collection. The different ventilation modes related respiratory mechanics indexes such as the esophageal pressure (Pes), the gastric pressure (Pga), the transdiaphragmatic pressure (Pdi), the maximum Pdi (Pdimax), Pdi/Pdimax ratio, the esophageal pressure-time product (PTPes), the gastric pressure-time product (PTPga), the transdiaphragmatic pressure-time product (PTPdi), the diaphragmatic electromyography (EMGdi), the maximum diaphragmatic electromyography (EMGdimax), PTPdi/PTPes ratio, Pes/Pdi ratio, the inspiratory time (Ti), the expiratory time (Te) and the total time respiratory cycle (Ttot) at the end of monitoring were recorded and compared between the two groups.Results:Compared with the T-piece group, Pes, PTPes, PTPdi/PTPes ratio, Pes/Pdi ratio and Te were higher in low-level assisted ventilation group [Pes (cmH 2O, 1 cmH 2O = 0.098 kPa): 2.84 (-1.80, 5.83) vs. -0.94 (-8.50, 2.06), PTPes (cmH 2O·s·min -1): 1.87 (-2.50, 5.93) vs. -0.95 (-9.71, 2.56), PTPdi/PTPes ratio: 0.07 (-1.74, 1.65) vs. -1.82 (-4.15, -1.25), Pes/Pdi ratio: 0.17 (-0.43, 0.64) vs. -0.47 (-0.65, -0.11), Te (s): 1.65 (1.36, 2.18) vs. 1.33 (1.05, 1.75), all P < 0.05], there were no significant differences in Pga, Pdi, Pdimax, Pdi/Pdimax ratio, PTPga, PTPdi, EMGdi, EMGdimax, Ti and Ttot between the T-piece group and the low-level assisted pressure ventilation group [Pga (cmH 2O): 6.96 (3.54,7.60) vs. 7.74 (4.37, 11.30), Pdi (cmH 2O): 9.24 (4.58, 17.31) vs. 6.18 (2.98, 11.96), Pdimax (cmH 2O): 47.20 (20.60, 52.30) vs. 29.95 (21.50, 47.20), Pdi/Pdimax ratio: 0.25 (0.01, 0.34) vs. 0.25 (0.12, 0.41), PTPga (cmH 2O·s·min -1): 7.20 (2.54, 9.97) vs. 7.97 (5.74, 13.07), PTPdi (cmH 2O·s·min -1): 12.15 (2.95, 19.86) vs. 6.87 (2.50, 12.63), EMGdi (μV): 0.05 (0.03, 0.07) vs. 0.04 (0.02, 0.06), EMGdimax (μV): 0.07 (0.05, 0.09) vs. 0.07 (0.04, 0.09), Ti (s): 1.20 (0.95, 1.33) vs. 1.07 (0.95, 1.33), Ttot (s): 2.59 (2.22, 3.09) vs. 2.77 (2.35, 3.24), all P > 0.05]. Conclusions:When mechanically ventilated patients undergo SBT, the use of T-piece method increases the work of breathing compared with low-level assisted ventilation method. Therefore, long-term use of T-piece should be avoided during SBT.

Correlation Analysis between Chromaticity Value and Quality Index of Atractylodis chinensis Decoction Piece Powder Stir-fried with Bran and Its Processing Time Study / 中国药房

OBJECTIVE：To analysis the correlation between chrom aticity value and quality index of Atractylodis chinensis decoction piece powder stir-fired with bran ，and to determine its processing time. METHODS ：The processed samples of 16 batches of A. chinensis decoction piece stir-fired with bran （S0-S15，S0 is the raw product of A. chinensis ）were prepared ，and chromaticity values of all samples were determined ，such as lightness value （L*），yellow blue value （b*），red green value （a*）. UPLC fingerprint of sample were analyzed ，and the contents of extract and volatile oil were also determined. Pearson correlation was used to analyze the correlation between the chromaticity value and quality index （relative peak area of each chromatographic peak in UPLC fingerprint ，water-soluble extract content ，alcohol-soluble extract content and volatile oil content ）. Multivariate statistical analysis （principal component analysis ，cluster analysis ，partial least squares discriminant analysis ）was carried out with chromaticity value and quality index ，and the processing time of A. chinensis decoction piece stir-fired with bran was determined by grey correlation method. RESULTS ：In the process of bran frying ，with the extension of processing time ，L* and b* of decoction pieces powder decreased ，and a* increased first and then decreased ；relative areas of peak 1 and peak 2 increased first and then decreased，while relative areas of peak 3（5-hydroxymethyl furfural ）increased，and the areas of the other peaks decreased. The content of the extract did not change significantly with time ，and the content of the volatile oil decreased. The results of correlation analysis showed that the relative peak area of peak 2-27，alcohol-soluble extract content and volatile oil content had a certain correlation with the chromaticity value ，while the relative peak area of peak 1 and water-soluble extract content had no linear correlation with the chromaticity value. Results of multivariate statistical analysis showed that the samples were divided into mild （S0-S5），excessive （S12-S15），moderate （S6-processing time of 18-33 min）. The results of grey correlation method showed that the processing time of A. chinensis decoction piece stir-fired w ith bran should be controlled in the range of 18-24 min，and the optimal processing time was 18 min. CONCLUSIONS ：There is a correlation between chromaticity value of A. chinensis decoction piece powder stir-fired with bran and the relative peak area of 27 chromatographic peaks ，and content of extract and volatile oil. It is suggested that the processing time should be 18 min.

Novel technique of sutureless glueless intrascleral fixation of single-piece intraocular lens / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore single centre results of sutureless intrascleral fixation of single-piece posterior chamber intraocular lens(IOL).<p>METHODS: In this prospective study, 50 aphakia cases were evaluated. Preoperative and postoperative visual acuity, slit lamp and fundus examination, applanation tonometry, keratometry, IOL MASTER measurement, optical coherence tomography(OCT), Scheimpflug imaging were done for an extensive evaluation.<p>RESULTS: All IOLs were successfully implanted at the desired position without intraoperative complications. Postoperative complications included corneal edema(<i>n</i>=2), raised intraocular pressure(IOP)(<i>n</i>=3), cystoid macular edema(CME)(<i>n</i>=1)and decentration(<i>n</i>=2). All were managed to the level of good visual recovery. Surgery videos were retrospectively evaluated in cases of postoperative complications. There was no significant change in corneal astigmatism.<p>CONCLUSION: After extensive 6mo follow up with evaluation of a variety of parameters, our technique of sutureless, glueless scleral fixation of IOL using single-piece IOL has shown favorable results and a potential option in visual rehabilitation.

Investigation and Analysis of the Dose Status of TCM Decoction Piece Prescription in 13 TCM Hospitals / 中国药房

OBJECTIVE：To provide reference for r ational use of TCM decoction piece. METHODS ：Electronic questionnaire survey was conducted on the use （dose，ingredient number ）of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces（regions，cities）. Through the hospital information system ，416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM （our hospital ）during May 2016 to Apr. 2019，and were analyzed in terms of prescription dose ，the number of ingredients and use of TCM decoction pieces. At the same time ，the use of TCM decoction piece prescription were analyzed in different departments ，and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS ：The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g，and the average number of ingredients were 11.90-18.25；the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g；55.75％ of the prescription dose were distributed in 201-300 g，and 15.22％ were over 300 g. The average number of ingredients in prescriptions was about 15，and the prescriptions with 11-20 ingredients accounted for 87.75％，those with more than 20 ingredients accounted for 6.64％. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar （85.51％），Atractylodes macrocephala stir-fried with bran （82.10％）and A. macrocephala（79.13％）. The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84％ in our hospital ；there were a lot of TCM prescriptions with dose exceeding 300 g（11.98％ and 18.69％）and the number of ingredients exceeding 18（14.60％ and 9.53％）in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09％. CONCLUSIONS ：The overall dosage of TCM decoction piece prescriptions is relatively high ，the number of ingredients is too much ，and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ，so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.

One-piece Implant Placement as an Alternative and Acceptable Treatment for Missing Tooth Rehabilitation: A Case Report

ABSTRACT@#Currently dental implant treatment become popular. More clinicians are being presented with the opportunity to perform implant services in their own practice. The use of one-piece implant can be considered as treatment for the replacement of missing tooth in the areas of limited tooth-to-tooth spacing and would bring less trauma for the soft tissue. A 52-year-old female patient presented with difficulty in mastication due to the loss of teeth of 35 region with limitation mesio distal space. Radiology examination did not reveal any radiolucencies in 35 region. Radiograph revealed sufficient bone height from crestal to the floor of the mandible. A one-piece implant was placed in the 35 region. The present case used an endosteal implant, one stage surgery, and delayed loading. Restoration with porcelain fused to the metal crown had been delivered three months after the one-piece implant placement. The result of this treatment indicated that one-piece implant could be considered as an effective therapy choice for replacement of missing tooth in order to rehabilitate the masticatory function.

Suitability survey on N95 filter masks for public health emergency personnel / 上海预防医学

Objective To assess the suitability of N95 masks for public health emergency personnel, and to compare the consistency between mask suitability test result and subjective evaluation of mask air tightness so as to guide scientific selection and use of protection masks for emergency personnel. Methods By ambient aerosol condensation nuclear counter method, qualitative suitability test was done among 235 public health emergency personnel from both municipal and district disease control centers.Questionnaires were conducted among them for investigation and comparison of their subjective evaluation of mask air tightness and mask suitability test results. Results Of the 235 subjects, 160 passed the suitability test with the pass rate being 68.1%. With various wearing actions for the test, the subjective evaluation for mask air tightness was compared with suitability test pass rate in terms of consistence, the kappa value range being from -0.09 to 0.43.The kappa value of the action 5 (loudly speaking) was above 0.4, while the kappa values of other 6 actions were all below 0.4.Both kappa value (0.09) and consistency rate (49.7%) were the lowest for action 8 (normal breathing) among all test actions. Conclusion The accuracy of the subjective evaluation for air tightness of the mask proves to be poor, unable to reflect the true protective effect and unable to substitute the suitability test.It is advised that the public health personnel should rely on the suitability test results to correctly choose and use suitable respiratory protective products.

Effect of Processing Technology on the Quality of Eucommia ulmoides and Recent Advances in Study on Its Chemical Composition and Pharmacology / 中国药学杂志

Eucommiae Cortex is a kind of traditional Chinese medicine. Its raw products and salt-processed products are often used to nourish liver and kidney and strengthen muscles and bones. Based on systematic study of literature, this paper summarizes the influence of processing technology on the quality of Eucommia ulmoides, as well as recent research progress in the chemical components and pharmacological effects of Eucommia ulmoides, in order to lay a foundation for the research of normalization and standardization of Eucommia ulmoides decoction pieces.

Application and thinking of intelligent pre-examination system of Chinese herbal pieces / 中草药

China's Prescription Management Measures stipulates that pharmacists shall examine and verify the appropriateness of drug use of prescription medication. Due to the complexity and diversity of TCM decoction piece, there has been no sufficient clinical report on the application of TCM prescription preview software. TCM prescription audit now stays on pharmacists' artificial trial stage. The points of intervention are reviewed in the middle and afterwards. It cannot be implemented in the same time when the prescription is prescribed by the clinician and previewed by the clinical pharmacist, which is called the preview of prescriptions. Due to the different abilities and experience of pharmacists in TCM treatment based on syndrome differentiation and the time limit of prescription preview, unqualified prescriptions are inevitably omitted during the review. Shanghai Yangpu District Hospital of TCM developed by cooperating with Shanghai Literature Pavilion "TCM Clinical Prescription Preview Audit System" was used to realize the intellectualization of the examination in advance to put forward, formed the real-time intervention. It realizes the intellectualization of "preview" prescription, combines manual "middle" and "afterwards" review and comment, and forms the whole-process monitoring of preview real-time intervention, reviewed in the middle and afterwards intervention, which greatly improves the rational rate of TCM prescriptions. The results of artificial group reviewed in 2018 and intelligent system reviewed in 2019 were applied to the method of comparative study. "TCM clinical prescription preview audit system" has obvious advantages over manual preview of TCM prescriptions. The advantage lies in that the intervention point of prescription review is advanced to the "preview" point, and the detection rate of unqualified prescriptions is significantly improved. Compared with the manual method, the intelligent method of TCM clinical prescription preview system has a great advantage in improving the rational clinical use of TCM prescriptions.

Study on the Effects of the Integration of Field Processing and Decoction Piece Processing on Chemical Com- position of Ligusticum chuanxiong Decoction Pieces / 中国药房

OBJECTIVE：To investigate the effects of the integration of field processing and decoction piece processing （hereinafter called “Integration”for short ）on chemical composition of Ligusticum chuanxiong decoction pieces. METHODS ：Fresh L. chuanxiong were collected from Dujiangyan and Pengzhou of Sichuan ；integrated decoction pieces of L. chuanxiong were prepared after washing ，drying in the shade （to about 28％ moisture content ），slicing and drying ；traditional decoction pieces was prepared after drying in the shade ，adding water to moisten （to the core ），slicing and drying. HPLC fingerprints of two kinds of decoction pieces samples （with 10 batches in each type ）were established. The determination was performed on WondaSil C 18 column with mobile phase consisted of 1％ formic acid solution-acetonitrile （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was 30 ℃. The detection wavelength was set at 285 nm，and the sample size was 10 μL. Using ligusticolide A as reference ，HPLC fingerprints of 20 batches of samples were drawn. The similarity of the fingerprints was evaluated with Similarity Evaluation System for Chromatographic Fingerprint of TCM （2004A edition ），and then common peaks were confirmed. The contents of chlorogenic acid ，ferulic acid and ligusticolide A were determined by above chromatographic condition. Single factor variance analysis was performed for comparison of the contents. RESULTS ：The similarity of HPLC fingerprints among 20 batches of samples was above 0.900. A total of 16 common peaks were determined ，7 of which were chlorogenic acid ，ferulic acid，ligusticolide Ⅰ，pine cypress ferulinate ，ligusticolide A ，n-butylphthalide and ligustilide ，respectively. The linear range of chlorogenic acid ，ferulic acid and ligusticolide A were 0.008-0.200 mg/mL（r＝0.999 9），0.010-0.140 mg/mL（r＝0.999 2）and 0.100-0.600 mg/mL（r＝0.999 3）；the limits of quantification were 0.002 8，0.000 6 and 0.005 0 mg/mL，respectively；the limits of detection were 0.000 8，0.000 1 and 0.001 0 mg/mL，respectively；RSDs of precision ，reproducibility and stability tests were all lower than 3％，and average recoveries were 96.27％-102.02％（RSD＜2％，n＝6）. The contents of above compositions in the integrated decoction pieces and traditional decoction pieces were（1.677 0±0.311 0），（1.562 7±0.124 5），（9.494 0±1.351 3）mg/g and（1.300 2±0.469 2），（1.388 0±0.209 9），（9.811 7±1.098 9）mg/g，respectively；there was no statistical significance between 2 groups（P＞0.05）. CONCLUSIONS ：The chemical composition of each batch of samples of L. chuanxiong integrated decoction pieces and traditional decoction pieces is consistent ，and the content of index components as chlorogenic acid ，ferulic acid and ligusticolide A in the decoction pieces is not affected by the integration processing. This process is feasible to a certain extent.

Comparative Study of Microbial Limit Test and Criteria of TCM Decoction Pieces among United States Pharma- copeia，European Pharmacopeia ，Japanese Pharmacopeia and Chinese Pharmacopeia / 中国药房

OBJECTIVE：To compare the difference of microbiological limit test and criteria of TCM decoction pieces among 43 edition of United States Pharmacopeia （USP43），10.0 edition of European Pharmacopeia （EP10.0），17 edition of Japanese Pharmacopeia （JP17）and 2020 edition of Chinese Pharmacopeia （ChP2020），and to provide refernce for the revision and improvement of microbiological standards for TCM decoction pieces in China. METHODS ：The differences in the microbial enumeration tests method （including sampling and sample preparation ，selection of bacteria and culture medium ，count of microorganisms and heat-resistant bacteria ，etc.），tests for specified microorganisms （including sample pretreatment ，enrichment， separation and identification ，etc.）and microbial related limit criteria were compared among USP 43，EP10.0，JP17 and ChP 2020. RESULTS & CONCLUSIONS ：In terms of microbiological examination of TCM decoction pieces ，USP43，EP10.0，JP17 had their own independent provisions. Chp 2020 added“general rule 1108”. In terms of inspection items ，in addition to the total aerobic bacteria count and total combined yeasts and molds count ，ChP2020 and EP 10.0 provided three methods for the inspection of control bacteria （bile-resistant Gram-negative bacteria ， Escherichia coli ， Salmonella）. On the basis ， JP17 supplemented Staphylococcus aureus test；However，USP43 added Clostridium test method and put forward the concept of objectionable microorganisms risk assessment ；ChP2020 also added a new method for counting heat-resistant bacteria. In terms of microbial limit criteria，USP43 was the most detailed in the classification of TCM decoction pieces ，which was more strict than EP 10.0 and JP 17； ChP2020 had not set up a unified limit for the inspection of control bacteria of TCM decoction pieces. ChP 2020 revised the “microbial limit standard for TCM extracts and TCM decoction pieces ”，but it was not perfect compared with the Pharmacopoeia of the United States ，Europe and Japan. It is suggested that according to the current situation of microbial contamination and control of TCM decoction pieces ，the microbial limit test and criteria of TCM related products in Pharmacopoeia should be gradually improved ，and the microbial limit level of corresponding products should be reasonably refined.