Mechanism of Hirudo in Treatment of Stroke： A Review / 中国实验方剂学杂志

Stroke is one of the most common cerebrovascular diseases， including hemorrhagic stroke and ischemic stroke. From a modern medical perspective， stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation. From the traditional Chinese medicine （TCM） perspective， the pathogenesis of this disease is mainly due to the disorder of Qi and blood， which ascend to the brain， causing either blood extravasation or blockage of brain collaterals. Stasis is a pathological factor that runs throughout the entire course of stroke， and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time. Hirudo， as a traditional insect drug， has shown good effects in promoting blood circulation and resolving stasis. Modern pharmacological research has confirmed that Hirudo contains anticoagulant components， which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke. Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation， anti-thrombosis， and protection of vascular endothelium. As a result， they have been widely used in the treatment of stroke. This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations， aiming to provide references for the involvement of Hirudo in stroke treatment.

A microprocessor-controlled prosthetic knee and its gait symmetry assessment / 中国康复理论与实践

ObjectiveTo present a method for evaluating the gait symmetry of microprocessor-controlled prosthetic knee (MPK). MethodsA kind of proto-MPK, AiKneeOne, and a wearable gait collect system, were made. The phases of the first double-limb support, the single-limb support, the second double-limb support, and the swing were used to calculate symmetry index (SI), ratio Ⅰ (RI) and ratio II (RII). Five heathy persons walked on the treadmill wearing AiKneeOne at speeds of 0.5, 0.7, 1.1 m/s, and the indice were collected with the wearable gait collect system. ResultsUnder different velocities, The absolute value of SI and RII were very little and the RI were close to one at the phases of the first double-limb support and the second double-limb support, but they were not very satisfactory in the phases of the single-limb support and the swing. ConclusionThe developed MPK AiKneeOne is potential to reconstruct the gait of amputees, and the gait symmetry indice can be used to evaluate the wearing performance of MPK.

Gait phase recognition in intelligent above-knee prosthesis based on fuzzy logic algorithm / 中国康复理论与实践

ObjectiveAiming at the need of control strategy switching of intelligent above-knee prosthetic, taking the plantar pressure of human walking as the research object, and based on fuzzy logic algorithm, a gait phase division method based on plantar pressure of prosthetic is proposed. MethodsThree flexible force sensors installed on the soles of the false feet were used to collect the plantar pressure information of the test object under three different walking modes (walking on the flat road, walking downhill and walking down the stairs). After data fusion processing, it was sent to the fuzzy logic controller, and the recognition results were output according to the IF-THEN rule, the scale and sensitivity factor. ResultsThrough the testing of five healthy people as substitute, the results showed that the accuracy of gait phase recognition for walking on the flat road, walking down the stairs and walking downhill were (95.3±2.4)%, (81.5±6.3)% and (90.7±3.5)%, respectively. ConclusionThe accuracy of recognition basically meets the requirements in this project. This method can be applied in the gait phase recognition of intelligent above-knee prosthetic.

Comparison of dosimetric differences in unintended irradiation of ipsilateral axillary region between intensity modulated proton and photon therapy for whole breast irradiation / 肿瘤

Objective:This study aimed to compare the dosimetric differences in unintended irradiation to the ipsilateral axillary region between intensity-modulated radiation therapy(IMRT)and intensity-modulated proton therapy(IMPT)in patients receiving whole breast irradiation(WBI). Methods:A total of 20 patients with early breast cancer who received WBI at our center between August and September 2022 were included in this study.One IMPT plan and one IMRT plan were formulated for each patient,with prescription dose of 4005 cGy(RBE)in 1 5 fractions.Dosimetric parameters of axillary lymph nodes(ALN)level Ⅰ,Ⅱ,Ⅲ,Rotter's lymph nodes(RN),and the axillary-lateral thoracic vascular junction(ALTJ)were compared between IMPT and IMRT plans. Results:All plans met the criteria of CTV V95％Dose≥95％.IMPT showed significantly better conformity index(0.97 vs 0.95,P=0.0003)and homogeneity index(0.05 vs 0.07,P=0.0301)compared to IMRT.The mean dose of the heart[27.48 vs 114.74 cGy(RBE),P＜0.0001]and ipsilateral lung[356.66 vs 498.89 cGy(RBE),P＜0.0001]were significantly lower in the IMPT plan compared to the IMRT plan.The mean dose,V50％Dose,V80％Dose,V90％Dose,and V95％Dose of ALNⅠ,ALN Ⅱ,ALN Ⅲ and RN in the IMPT plan were significantly lower than those in the IMRT plan(all P＜0.01),with the most significant difference observed in the dosimetric parameters of the axillary region inferior to the axillary vein[mean dose:79.75 vs 995.31 cGy(RBE),P＜0.0001].The mean dose and serial dosimetric parameters(V5,V10,V15,V20,V25,V30,and V35)of the ALTJ were also significantly lower in IMPT plans compared to IMRT plans. Conclusion:IMPT demonstrates lower unintended irradiation dose in the inferior axillary region and reduces dose volume in the ALTJ region compared to IMRT.When employing IMPT,the clinical target volume(CTV)should be delineated based on the individual locoregional recurrence risk for patients with positive sentinel lymph nodes who omitted axillary lymph node dissection.For high-risk patients,the axillary region should be included in the CTV to ensure efficacy,while for low-risk patients,excluding the axillary region can help mitigate the risk of breast cancer-related lymphedema.

Research and comparison of electronic data capture systems used in clinical researches / 中华医学科研管理杂志

Objective:To provide a reference for the choice of electronic data capture system used in clinical research, the function and performance of some tool software were expounded and compared.Methods:We selected three freely available systems of REDCap, Commcare, and OpenEDC as research objects, describing and comparing their user license acquisition path, data capture related functions, and information security assurance measures. This article reflected how the three kinds of tool software ensure research data privacy and scientificity, and presented the consideration of system security and accessibility.Results:REDCap was the most mature system of the three, which had a fairly comprehensive design in functional integrity, data security, user friendliness, and system scalability. Commcare system featured in the mobile collection, and supported the most abundant types of collected data, while OpenEDC was characteristic of low threshold and flexible deployment.Conclusions:REDCap system is widely applicable to small and medium scale medical research, including clinical trials, retrospective studies, cohort studies, and translational research. Commcare system is the preferred option for medical investigations represented by epidemiologic surveys, while OpenEDC is particularly suitable for investigator initiated studies.

Mechanism of Ferroptosis and Traditional Chinese Medicine Intervention on Neuronal Cell Ferroptosis After Stroke： A Review / 中国实验方剂学杂志

Stroke is a common cerebrovascular disease， characterized by high incidence， mortality and disability rate. Neuronal cells， the basic unit of the central nervous system， can be injured to varying degrees when stroke occurs. Neuronal cell injury after stroke is also the key cause leading to neurological dysfunction， affecting the prognosis and quality of life of patients. Therefore， reducing the neuronal cell injury and delaying the process of cell death are effective to decrease the nerve function injury in stroke patients and improve their prognosis， thus lowering the death and disability rate of stroke. Ferroptosis is a new form of cell death that has been widely concerned in recent years. Several studies have confirmed that there is ferroptosis in neuronal cells after stroke. Since ferroptosis is an adjustable form， its intervention can help regulate the injury and death of neuronal cells. Studies have shown that inhibiting ferroptosis plays a role in protecting neuronal cells. Traditional Chinese medicine （TCM）， with the multi-channel and multi-target treatment advantages， has been widely used in the whole stroke and has achieved good clinical efficacy. It might be a new direction taking TCM regulation of ferroptosis as the entry point for stroke treatment in the future. This review revealed the mechanism of ferroptosis， discussed the research status of TCM in intervening in neuronal cell ferroptosis， and provided reference for further improving the efficacy of TCM in stroke.

Fluids intake, volume of urine and hydration status among male college athletics in one university of Beijing in spring / 中国学校卫生

Objective@#To investigate and analyze the fluids intake, urine output and hydration status during spring among male college athletics from one university in Beijing, and to provide scientific evidence for launching targeted health education.@*Methods@#A simple random sampling method was used to select 109 male students in college with habit of exercise.Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire. The water from food was assessed by the duplicate portion method and the weight method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality and specific gravity of urine were measured. The energy expenditure in exercise was estimated by using the exercise plan.@*Results@#The median drinking fluids intake, water from food, total fluids intake and urine volume were 1 789, 955, 2 701, 850 mL/d, respectively. 15.6% of the subjects were in proper hydration status, and 43.1% of the subjects were in dehydration. The differences between drinking fluids intake, water from food, total fluids intake and urine volume of subjects in the different BMI and BF% levels were not significant(P>0.05). The differences between drinking fluids intake and total fluids intake of subjects in the different energy expenditure in exercise levels were significant(χ2=9.20, 8.43, P<0.05).@*Conclusion@#Comparing with the normal college students, the drinking fluids intake and total fluids intake of male sports people were higher, the volume of urine was lower, and the hydration status was worse. The targeted health education about water intake was recommended.

Types of fluid intake during spring among college students in Hebei Province / 中国学校卫生

Objective@#To investigate the total amount and types of fluid intake among college students in Hebei Province during spring and to provide scientific basis for fluid-intake education.@*Methods@#A simple random sampling method was used to select 156 college students from a college in Hebei Province. The information on amount and type of fluid intake was recorded using the 7-day 24-hour recording method. A separate analysis was performed on people who consumed beverages during the 7 days.@*Results@#The median intake of plain water, milk, sugar-sweetened beverages and other beverages was 866 mL, 43 mL, 43 mL and 2 mL, respectively. The median of plain water, milk, sugar-sweetened beverages and other beverages by the beverage-consumers was 845 mL, 36 mL, 63 mL and 11 mL, respectively. The intake of plain water and sugar-sweetened beverages in male students was significantly higher(Z=2.31, 3.03; 2.31, 2.11, P<0.05), and milk consumption was lower than female students of these two groups of people(Z=-2.73, -2.23, P<0.05). The intake of other beverages in male students was higher than that of female students, but only significant among beverage-consumers(Z=3.31, P<0.01). There was no significant difference in the total amount of different fluid types among different BMI(P>0.05).@*Conclusion@#College students in Hebei Province mainly drink plain water. Sex difference is observed in the types of fluid intake.

Nutritional knowledge-attitude-practice among students in six cities of China / 中国学校卫生

Objective@#To understand nutrition knowledge,related attitude and behavior among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies.@*Methods@#A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in 6 cities of China, whom were administered with a questionnaire survey on nutrition knowledge, practice and practice.@*Results@#Average nutritional knowledge was relatively low (12.0±6.4), practice score was moderate(11.4±2.4), while nutritional attitude was relatively high(17.0±2.4). The nutritional KAP scores of girls were higher than those of boys; the nutritional knowledge and practice scores of urban students were higher than those of suburban students; the nutritional knowledge score of fifth-grade students was higher than that of fourth-grade students(P<0.05). The overall nutritional knowledge awareness rate was 26.1%, with the highest in knowledge of whole grains(73.9%). About 83.5% of the students held positive nutritional attitude, 97.6% considered nutritional knowledge important. The overall rate of healthy eating behavior of students was 88.1%. Most students had breakfast almost every day(88.5%). About 34.9%, 38.0%,46.1% and 50.5% were reported of rarely consumption in snacks, fast food and drinks. Students in urban area and grade 5 were more likely have breakfast. Girls reported higher rates of having breastfast and low consumption of snack food and beverage while boys reported higher consumption of fast food. Students from suburban areas reported high consumption of western fast food but lower beverage(P<0.05). The score of students’ nutritional knowledge was positively correlated to attitude, so as attitude and practice(P<0.05).@*Conclusion@#Insufficient nutritional knowledge and unhealthy dietary behavior is observed in primary school students in China. Nutritional K-A-P varies in students with different gender, area and grade. Specific nutritional education in school-setting should be developed accordingly to culture healthy lifestyle among primary school students.

Food intake frequency among grade four and grade five primary school students in six cities of China / 中国学校卫生

Objective@#To understand food intake frequency among primary students in six cities of China, and to provide evidence for nutrition education and intervention strategies.@*Methods@#A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing，Guangzhou,Nanjing,Chongqing,Jinan,Harbin. All the participants were administered with a self-administered questionnaire on dietary behaviors.@*Results@#For the fourth and fifth grade primary school students, the highest proportion of "almost every day" was fresh vegetable(83.2%), and the highest proportion of "nearly eaten" was oat (50.2%). There was a remarkable difference between children of different genders, areas and grades. The intake of whole grains, meat and poultry, fishery products, eggs, soybeans and nutritional supplements of boys was higher than that of girls, while the intake of oats, fresh vegetables, fruits, fungi and algae of girls was higher than that of boys. The intake of oats, vegetables, fruits, fungi and algae, meat and poultry, milk of central urban areas students was higher than that of suburban areas students, while the intake of fishery products, soybeans and nutritional supplements of suburban areas students was higher than that of central urban areas students. The intake of oats, fresh vegetables, fruits, meat and poultry, eggs, milk and soybeans of fifth grade students was higher than that of fourth grade students, while the intake of whole grains, fishery foods and nutritional supplements of grade 4 students was higher than that of grade 5 students. The differences were all statistically significant(P<0.05).@*Conclusion@#The frequency of food intake varies among students of different genders, urbanities and grades. School teachers, parents and community workers should make efforts targeting at students with different characteristics to enhance nutritional literacy and cultivate healthy eating behaviors.

Fast food consumption among grade four and grade five primary school students in six cities of China / 中国学校卫生

Objective@#To understand the status on fast food consumption among grade 4 and grade 5 primary school students in six cities of China, and to provide evidence for nutrition education and intervention strategies.@*Methods@#A multi-stage stratified cluster random sampling method was used to select 12 197 grade 4 and grade 5 primary school students from 72 primary schools in Beijing, Guangzhou, Nanjing, Chongqing, Jinan and Harbin. All the participants were investigated with a self-administered questionnaire survey of dietary behaviors.@*Results@#Students consumed western fast food 1.48 times a week and Chinese fast food 2.08 times a week on average, which shows significant differences (χ2=643.86, P<0.05). The main reasons for choosing Chinese fast food were delicious(73.8%), nutritious(69.9%), safe and clean(52.2%), convenient (45.9%) and eating surrounding (41.4%), and for western fast food were delicious(80.1%), eating surrounding(53.0%), convenient(44.2%), safe and clean (41.6%) and nutritious(40.6%). Boys paid more attention to deliciousness and convenience, girls paid more attention to cleanliness and nutrition. About 43.9% of the students were aware of the high calorie in western fast food.@*Conclusion@#The consumption of fast food is popular among primary students. Schools and other relevant departments should launch nutrition education, deliver sufficient nutrition knowledge，help students establishing a good diet habit and reduce the consumption of western fast food with high calories.

Application of link mechanism in otolaryngology chair / 中国医疗器械杂志

Design otolaryngology chair's up-down assemble by applying link mechanism. And analysing the speed and accelerate of mechanism in CATIA's motion mechanism module to verify its actual running status. Draw the effective design, make the successful prototype.

Effects of foliar iron application on iron concentration in polished rice grain and its bioavailability.

Iron (Fe) deficiency in humans caused by inadequate dietary intake is a global nutritional problem. A glass house pot experiment was conducted to evaluate the effect of foliar FeSO4 containing applications on concentrations of Fe, Zn, and Fe bioavailability in polished rice among five rice cultivars. The results showed that foliar application of FeSO4, FeSO4, plus nicotianamine (NA), and FeSO4 plus NA with ZnSO4 increased the grain Fe concentration by 16.97%, 29.9%, and 27.08%, respectively. The grain Fe bioavailability also increased by foliar application of FeSO4, FeSO4 plus NA, and FeSO4 plus NA with ZnSO4; these represent increases of 12.63%, 20.86%, and 18.75%, respectively. Foliar FeSO4 containing applications improved the Fe bioavailability and might be attributed to the reduction of phytic acid and the increase of Fe concentration in polished rice. Addition of ZnSO4 to foliar Fe application increased both Fe and Zn content without altering Fe content and bioavailability. In addition, the cultivar difference in Fe and Zn concentration was observed and may be due to the genetic control of leaf absorption and seed deposition of foliar application. Furthermore, the cultivar difference in Fe bioavailability observed might be attributed to the variation of grain Fe, phytic acid, and total phenolics contents among the five rice cultivars. The results suggested that foliar FeSO4 containing applications represent a promising agricultural approach to reduce Fe deficiency in countries where polished rice is extensively consumed.

Delineation and measurement of the coronary artery and evaluation the dose to the descending coronary artery by different breast cancer radiotherapy techniques / 中华放射肿瘤学杂志

Objective To delineate and measure the left anterior descending coronary artery (LAD) on CT angiography (CTA) and evaluate the dose delivered to LAD by different radiotherapy techniques for left-sided breast cancer.Methods Twenty-nine left-side breast cancer women with mean age of 54.71 years (range:30-80 years) were included.CTA was performed, and LAD was contoured and the distances were measured between LAD and chest wall (posteroanterior diameter,PD), between LAD and internal mammary artery (horizontal diameter,HD), between LAD and interventricular groove (oblique diameter,OD) at the level of T7-T8,T8-T9,T9-T10 and at level of nipple and lower boundary of the breast.The dose delivered to LAD was calculated on three-dimensional plans for two patients with mastectomy whose chest wall and internal mammary chain (IMC) were irradiated and one patient with breast-conserving surgery who received whole breast irradiation.Results The LAD arose at the level of the third rib in 40% of patients and at the fourth rib in 60% of patients.The mean length of LAD was 7.49±0.58 cm.At the level of T7-T8,T8-T9,T9-T10,the mean PD were 2.99±1.11 cm, 1.26±0.65 cm,0.68±0.39 cm, the mean HD were 2.27±0.84 cm, 2.81±0.65 cm, 3.37±1.21 cm, and the mean OD were 0.47±0.25 cm,0.38±0.21 cm,0.42±0.19 cm respectively.At the level of the breast nipple and the lower boundary of the breast, the mean PD were 2.94±1.06 cm, 0.79±0.46 cm, the mean HD were 2.45±0.89 cm, 3.31±1.22 cm,and the mean OD were 0.56±0.30 cm,0.57±0.24 cm respectively.The mean dose to the LAD was 5 Gy and 14 Gy for patients with mastectomy whose IMC was irradiated with 9 MeV electron and whose IMC was irradiated with 6 MV photon tangential beams.The mean dose to the LAD was 26 Gy for patients with breast conserving surgery.Conclusions To contour the LAD, the interventricular groove could be the reference point.Tangential technique can be giving a higher dose of LAD when compared with other radiation techniques

The application of the semi-automatic biopsy needle in indolent and minimally invasive muscle biopsy for the patients with psudohypertrophic muscular dystrophy / 中华全科医师杂志

Five hundred and twelve patients with psudohypertrophic muscular dystrophy underwent rapidly minimally invasive muscle biopsy with TZ semi-automatic biopsy needle under intravenous anesthesia. Three hundred and seventy nine samples were taken from quadriceps femoris muscle, while other 133 samples were taken from the deltoid muscle. The pathological diagnosis was obtained in all patients and there were no complications after biopsy. The results indicated that this method was simple, safe, effective, indolent, and minimally invasive. The obtained muscle samples can meet the request of histopathological and immunohistochemical examination and the method should be recommended for clinical applicatioa.

Stem cell transplantation for ischemic femoral head necrosis Analysis in 20 model rabbits and 188 patients / 中国组织工程研究

BACKGROUND: Ischemic femoral head necrosis is caused by local vascular injury and blood-supply insufficiency. There exists no optimal treatment for the ischemic femoral head necrosis. Thus, the improvement of the blood supply to the femoral head seems to be a key point for the treatment. OBJECTIVE: To verify the curative effects of autologous bone marrow mesenchymal stem cell transplantation induced vascular regeneration on the improvement of ischemic femoral head necrosis via animal experiments and clinical observations. DESIGN: Contrast animal experiment and self-controlled clinical observation.SETTING: Cell Therapy Center, the 463 Hospital of Chinese PLA.MATERIALS AND PARTICIPANTS: ① Animals: Twenty Japanese white rabbits in either gender and weighing 3.0-4.0 kg were purchased from Animal Experimental Center, General Hospital of Shenyang Military Area Command of Chinese PLA. The animal experiments were coincident with the ethical standards. ② Participants: 188 patients with ischemic femoral head necrosis (335 hips) having whole following-up data were selected from Cell Therapy Center, the 463 Hospital of Chinese PLA from July 2004 to July 2007. There were 113 males and 75 females, and their ages ranged from 18 to 72 years. Diagnosis was done by using X-ray photographs, nuclide scanning, MRI and CT examinations. All patients provided the informed consent, and the study was approved by the local research ethics committee. METHODS: ① Animal experiments: The experiment was carried out at the Animal Experiment Center, General Hospital of Shenyang Military Area Command of Chinese PLA from January to June 2004. Ischemic femoral head necrosis models were established at both hindlimbs by using liquid-nitrogen refrigeration. The right side was regarded as transplantation group and the left one as control group. Mononuclear cells extracted from bone marrow were poured in the right femoral artery, while saline was poured in the left femoral artery. ②Clinical observations: Mononuclear cells were separated from autologous bone marrow of patients with ischemic femoral head necrosis after density gradient centrifugation. MAIN OUTCOME MEASURES: ①Four weeks later, angiogenesis at both femoral arteries was observed by arteriography by using digital subtraction anglography (DSA). Moreover, bilateral femoral head samples underwent pathological sections to observe bone regeneration and repair of femoral head 4 and 12 weeks later. ②Items including hip pain, walking distance and gait, abduction and internal rotation function changes of hip joint were observed in 3, 6, 12 and 24 months after stem cell transplantation in media femoral circum flex artery, lateral femoral circum flex artery and obturator artery. In 6 months after stem cell transplantation, angiogenesis and blood supply of femoral head were observed by using arteriography. In 6, 12 and 24 months after stem cell transplantation, morphological and ischemic changes of femoral head were observed by using CT, X-ray and MRI examinations. Harris scores were used to evaluate function of hip joint before and in 3, 6, 12 and 24 months after stem cell transplantation.RESULTS: Animal experiment: Twenty rabbits were involved in the final analysis. ① DSA-arteriography results: In 4 weeks after transplantation, blood-supply arteries in femoral head of right hindlimb in the transplantation group were more than those in the control group. ② Pathological results: In 12 weeks after transplantation, cartilage, lamellar bone and bone trabecula in the left femoral head were repaired remarkably, but left femoral head necrosis was not improved. Clinical observations: 188 patients were involved in the final analysis. ① Improvement of symptoms: Among 188 patients, 164 (87.3%) had remission of hip pain, 147 (78.4%) had function improvement, and 150 (80.0%) had elongation of walking distance. ② Imaging changes: At 6 months after transplantation, DSA-arteriography in 12 patients demonstrated that blood-supply arteries in femoral head were increased and thickened remarkably as compared with those before transplantation, and the blood flow was rapid. At 12-24 months after transplantation, lesion of bone matrix in 24 patients was improved under the X-ray, CT and MRI examinations. ③ Harris scores of hip joint: The scores at 6, 12 and 24 months after transplantation were significantly higher than those before transplantation (t= -3.423, -6.714, -9.039, P < 0.01).CONCLUSION: Autologous bone marrow mesenchymal stem cell transplantation can effectively improve and treat ischemic femoral head necrosis.

Determination of multiclass pesticide residues in apple juice by gas chromatography-mass selective detection after extraction by matrix solid-phase dispersion.

A multiresidue method is described for the analysis of 106 multiclass pesticides (organochlorine, organophosphate, carbamate, pyrethroid, and triazine classes) in apple juice in a single injection. The determination procedure was based on matrix solid-phase dispersion of juice on diatomaceous earth in a glass column and subsequent extraction with a mixture of hexane-dichloromethane (1 + 1) at a flow rate of 5 mL/min. The analytes were determined by capillary gas chromatography with mass spectrometric detection and confirmed by their retention times and ion ratios. The coefficients of variation for analysis of samples fortified over the range of 0.01-0.2 mg/kg were 1.62 to 18.4%, and the recoveries for all analytes were between 70 and 110%.

Effect of Peer -Education model on clinical practice of undergraduate interns / 中华医学教育探索杂志

Objective To investigate the effect of peer-education model on clinical practice of undergraduate interns.Methods Thirty-six undergraduate interns were arranged into control and experimental group.Twelve postgraduates were selected as peer-educators.Medical ethics and style,attitude,clinical thoughts,operations and satisfactory of patients were used to judge their work.They had to take exams at the end of the clinical practice.Results Undergraduate interns in experi-mental group got higher scores than control group.Conclusion Peer-education model has a posi-tive effect on clinical practice of undergraduate interns.

Selection of treatment for periampullary carcinoma complicated with acute cholangitis / 中国普通外科杂志

Objective To evaluate the therapeutic approach for patients with periampullary carcinoma (complicated) with acute cholangitis. Methods A comparative analysis of the clinical data of cases of (periampullary) carcinoma with acute cholangitis who were admitted and treated in our hospital during a 12-year period.They included 25 cases who underwent primary resection, and 12 cases who underwent a two-stage resection with initial bile duct drainge. Results After conservative procedures, the preoperative temperature and WBC of patients in primary resection group were much lower than when admitted(P0.05). Total bilirubin and albumin levels showed no significant changes. Compared with the two-stage resection group,the primary resection group had shorter preoperative preparation time, shorter operation time, lesser intra-operative blood loss, but higher postoperative infection complication rate and prolonged length of hospital stay(P0.05). Conclusions Patients with periampullary carcinoma complicated with acute cholangitis can initially be treated conservatively . After biliary infection is controlled, primary (pancreatoduodenectomy) is performed.

Clinical significances and relationship between vascular endothelial growth factor expression and microvessel density in gastric carcinoma / 中国普通外科杂志

Objective　To evaluate the correlation between vascular endothelial growth factor(VEGF) expression and microvessel density(MVD) in gastric carcinoma (GC) and the relationship of VEGF and MVD with clinicopathologic characteristics and prognosis of GC. Methods　The expression of VEGF and intratumoral microvessel density (MVD) in one hundred and sixteen resected specimens of the patients with GC were observed and counted, and the relationship of VEGF and MVD with clinicopathologic factors and prognosis of GC were analysed. Results　The expression of VEGF was found in 60.34% of the specimens. The MVD value was much higher in VEGF(+) group than that in VEGF(-) group (26.16±8.50 and 19.22±8.20, respectively, P<0.01). Expression of VEGF was significantly higher in patients with lymph node metastasis than that in patients without lymph node metastasis (p<0.05).Expression of VEGF was highly correlated with the stage of tumor (P<0.05). MVD correlated with lymph node metastasis (P<0.01) and abdomen metastasis (P<0.01) and increased with the TNM stage (P<0.01). The total five-year survival rate in VEGF(-) group and low MVD group were significantly higher than that in VEGF(+) group and high MVD group respectively(both P<0.01). Multivariate analysis indicated that the expression of VEGF and MVD were independent prognostic factors of GC. Conclusions　The expression of VEGF and MVD can reflect the malignant degree of GC. They may serve as the prognostic factors and guide the decisions on the therapy.