Objective To research the application of oral ambroxol in improving positive rate of sputum smear laboratory testing of Tuberculosis.Methods After immediate microscopic phlegm examination on 1 536 tuberculosis outpatients,them were divided into two groups alternatively and randomly.The referential group took oral placebo while the test group took oral ambroxol.Recheck would be conducted onmorning phlegm after three days,then comprated the positive rate of each group.Results The positive rates of immediate microscopic phlegm examination of the referential and test groups were 4.82％ and 4.56％ (x2 =0.058,P＞0.05) respectively.For the referential group,the positive rates before and after taking medicine were 4.82％ and 5.60％ respectively (x2 =0.475,P＞0.05).The differences had no statistic meaning.The positive rates of morning microscopic phlegm examination after taking medicine of the referential and test groups were 5.60％ and 8.59 ％ ()x2 =5.224,P＜0.05) respectively.The positive rates of the test group before and after taking medicine were 4.56 ％ and 8.59％ respectively (x2 =10.18,P＜0.05).It could be deemed that the difference had statistic meaning.Conclusion O-ral ambroxol can help raise the positive rate of microscopic phlegm examination of the patient with suspected tuberculosis.

This study was aimed to discuss the ways of converting clinical data entered in the Case Report Form (CRF) to Study Data Tabulation Model (SDTM) database format in clinical research of traditional Chinese medicine (TCM). Currently, there were three approaches for implementing SDTM, which were the pure SDTM approach, submission-only approach and database-only approach. This article compared and analyzed advantages and disadvantages of three approaches and introduced experiences of the Clinical Evaluation Center of China Academy of Chinese Medical Sciences using database-only approach for SDTM implementation. The results showed that pure SDTM approach can maximally embrace SDTM standards. However, the current process and software system should be modified. Therefore, it was time-consuming and expensive. The submission-only approach was the most economic way in the application of SDTM standards. However, the data quality and traceability may not be guaranteed. The database-only approach built the study database based on the SDTM standard by writing transformed program before data entry while the data collection system was not SDTM-compatible. It was concluded that database-only approach for implementation SDTM was a suitable and practical way to TCM clinical research.

Objective Serum uric acid (SUA) levels have been identified to be associated with nonalcoholic fatty liver disease (NAFLD) which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index (BMI) people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people. Methods A total of 2 193 normal-BMI people (1 106 men and 1087 women) who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD. Results Compared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males,(339.0±47.6)μmol/L vs.(309.3±53.5)μmol/L, t=3.296, P<0.01;female,(273.6±41.6)μmol/L vs. (243.9 ± 47.6)μmol/L, t=3.178, P<0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher (P<0.05) odds ratio for the presence of NAFLD than the lowest quartile [males,odds ratio:2.508(1.255-3.374)and 3.383(2.058-5.490);females,odds ratio:2.186(1.090-4.384) and 2.420(1.214-4.821),respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status.Conclusions Increased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people.

Objective To study the effects of total saponins of panax notoginseng on the proliferation of bone marrow strowal cells during differentiating into neuron-like Cells in vitro. Methods BMSCs were isolated from femur and tibia of rats and cultured in basal medium(Control),dimethylsulfoxide(DMSO) and butylated hydroxyanisole(BHA) in basal medium as induction group and containing PNS 100mg/L induction medium as PNS group. The morphological changes were observed under inverted microscope.The differentiated BMSCs were detected by immunohistochemistry,and the proliferation were evaluated by MTT assay.Results During induction differentiation,nestin was expressed by all BMSCs with ball-like shape and short process.The nestin expression of PNS group increased as compared with induction group(P

Objective To isolate and cultivate Long-Evans rat bone mesenchymal stem cells (BMSCs) and identify their biological characteristics. Methods BMSCs were obtained from femurs of Long-Evan rats and dealt with 0.85 NH4Cl. The cell growth curve and cell cycle were measured and surface antigens were detected by flow cytometry. Osteoblast differentiation was studied by Alizarin red staining. Results BMSCs had active proliferative ability. The growth velocity of passage 5 cells was slower than that of passage 3 cells. The cell cycle analysis showed that 93.79 of BMSCs was at G0/G1 phase. BMSCs were positive for CD29 and CD44, but negative for CD45. Alizarin red staining of BMSCs after osteoblast induction was positive. Conclusion Highly purified BMSCs obtained from Long-Evan rats by 0.85 NH4Cl show stable biological properties.

Objective: To synthesize the zinc-doped carbon dots (CDs) by hydrothermal method and to observe the inhibitory effects of zinc-doped CDs combined with blue light on the formation of Staphylococcus aureus (S. aureus), and to explore the related mechanism. Methods: The zinc-doped (CDs) were synthesized by hydrothermal method, and the characteristics were observed by transmission electron microscope ( TEM). fluorescence spectrometer and Fourier transform-infrared spectrometer (FT-IR). The experiment was divided into blank control group. CDs group, blue light radiation group, and CDs +blue light radiation group. The cells in CDs group were treated with different concentrations (50. 75. 100 mg • L ' ) of CDs. the cells in blue light radiation group were irradiated with blue light for 10. 20. and 40 min. the cells in CDs + blue light radiation group were treated with CDs combined with blue light, and the cells in blank control group were only treated by culture medium in the dark. CCK-8 assay was used to determine the proliferation rates of the L929 and MC3T3-E1 cells. The reactive oxygen species were scavenged by adding N-acetylcysteine (NAC) in the best bacteriostatic effect group (100 mg • L ' CDs group), and the experiment was divided into contro group. 100 mg • L ' CDs group. 0.5 mmol • L 'NAC group, and 0.5 mmol • L ' NAC+ 100 mg • L ' CDs group. The concentrations of the bacteria suspension in various groups were detected by spectrophotometer, the bacterial biofilm formation amounts of S. aureus in various groups were detected by crystal violet staining, and the plate count method was used to record the colony counts in various groups. Results: The TEM results showed that the particle size of the zinc-doped CDs constructed successfully was about 1. 8 nm. The fluorescence spectra showed that the optimum excitation wavelength of CDs was 342 nm and the optimum emission wavelentgh was 450 nm. The FT-IR spectrum showed that CDs had hydroxyl. carboxy. amino and other functional groups. TheCCK-8 assay results showed that after co-culture for 24 h. the proliferation rates of L929 and MC3T3-E1 cells in 100 mg • L ' CDs group were up to 80%. Compared with blank control group, the concentrations of bacteria solution in blue light radiation for 20 and 40 min groups were decreased ( P<∗0. 05 or P<.0. 01). the biofilm formation amount of S aureus was decreased after blue light radiation for 40 min ( P<0. 01). Compared with blue light radiation group, the concentration of bacteria solution and the biofilm formation amount of S. aureus in CDs + blue light radiation (10 min) group were decreased after blue light radition for 10 min ( P<0. 01). Compared with 100 mg • L ' CDs group, the concentration of bacteria solution and the biofilm formation amount of bacteria in 0. 5 mmol • L 1 NAC+100 mg • L ' CDs group were increased (P<0.01). Conclusion: Zinc-doped CDs combined with blue light can inhibit the growth of S aureus and the biofilm formation by photocatalysis effectly.

Objective To discuss the methods and the effects of percutaneous kyphoplasty(PKP)in the treatment of thoracolumbar osteoporotic vertebral compression fractures ( OVCFs).Methods Retrospective analysis was made on 110 vertebrae in 96 thoracolumbar OVCFs patients undergoing transpedicular unilateral PKP or PKP combined with percutaneous vertebroplasty(PVP) from Jan.2004 to Nov.2011.We analyzed the change of the anterior heights of the vertebra,the clinical outcomes using VAS and Oswcstry bcforc and after the treatment,and the rate of cement leakage.Results 85 vertebrae were treated with the PKP sucessfully,and 25 vertebraewere treated with both PKP and PVP sucessfu]ly.All patients were satisfied with the diffusion of the cement.Theoperation time of each vertebra was about 20-40 minutes for one side.The injection volume of of each vertebrawas about 5.4 ml.According to VAS and Oswestry,the pain was alleviated obviously after the operation ( P ＜0.01) and the anterior heights of the vertebrae changed ( P ＜ 0.01).The leakage of the cement was the only complication in these patients and most of the leakage happened at the anterior of the vertebrae and the vein nearby.The overall rate of the leakage was 56.3％.For the 40 vertebrae of the 36 patients that were followed up,1patient had fracture in a neighbor vertebra and 1patient had subsidence in the upper anterior edge of the treated vertebra where there was no cement filled in,but the patient had no discomfort.Conclusion PKP or PKP combined with PVP are safe,convenient and effective methods in treating OVCFs.

BACKGROUND:Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. ＜br> OBJECTIVE:To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. ＜br> METHODS:One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. ＜br> RESULTS AND CONCLUSION:The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.

BACKGROUND: Al ogeneic hematopoietic stem cel transplantation is the main method to cure leukemia, but the patients receiving al ogeneic hematopoietic stem cel transplantation stil have to face the risk of recurrence. Myeloid sarcoma is a rare extramedul ary relapse mode with worse clinical outcomes, so it is necessary to understand the characteristics of myeloid sarcoma and relative treatment methods. OBJECTIVE: To analyze the clinical characteristics and treatment methods of myeliod sarcomas in cardio-phrenic angle after al ogeneic peripheral blood stem cel transplantation. METHODS: One case was diagnosed as single myeloid sacoma in the cardio-phrenic angle after al ogeneic peripheral blood stem cel transplantation. The patient underwent surgical resection of the mass, chemotherapy and radiotherapy. The clinical effect, complications and survival situation were observed. RESULTS AND CONCLUSION: The patient suffered from bacteremia, fungal pneumonia and even life-threatening sepsis shock during two courses chemotherapies. Then, the patient received radiotherapy for mediastinum and the myeloid sacoma never relapsed. However, the patient suffered central nervous system leukemia after free of the disease for 25 months. Myeliod sarcoma after al ogeneic hematopoietic stem cel transplantation is rare and its manifestation is changeful. The diagnosis mainly depends on histopathology and immunohistochemistry. Surgery, chemotherapy, radiotherapy, second transplantation and molecular targeted drugs are the choices of treatment strategy. However, the optimal treatment strategy for individual patients remains to be determined.

Objective:To investigate the influencing factors for the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 1 396 patients who underwent Da Vinci robotic or laparoscopic radical gastrectomy for gastric cancer in the First Affiliated Hospital of Nanchang University from December 2014 to July 2019 were collected. There were 991 males and 405 females, aged (60±11) years. Surgery using Da Vinci robotic system or laparoscopic system was completed according to patients' wishes. Cases with early gastric cancer underwent D 1+ lymphadenectomy and cases with advanced gastric cancer underwent standard D 2 lymphadenectomy. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) influencing factors for the number of lymph node harvested after radical gastrectomy for gastric cancer; (4) follow-up and survival. Follow-up using outpatient examination or telephone interview was performed to detect survival of patients up to October 2020. Measurement data with normal distribution were represented as Mean± SD. Univariate analysis was done using the chi-square test or Fisher exact probability. Multivariate analysis was performed using Logistic regression model. The survival rate was calculated by Kaplan-Meier method. Results:(1) Intraoperative situations: all the 1 396 patients underwent radical gastrectomy, including 415 cases undergoing Da Vinci robotic radical gastrectomy and 981 cases undergoing laparoscopic radical gastrectomy. Thirty-five of the 1 396 patients were converted to open surgery, including 5 cases undergoing Da Vinci robotic radical gastrectomy and 30 cases undergoing laparoscopic radical gastrectomy. Of the 1 396 patients, 983 cases underwent distal gastrectomy, 400 cases underwent total gastrectomy and 13 cases underwent proximal gastrectomy, among which 597 cases underwent Billroth Ⅰ anastomosis, 385 cases underwent Billroth Ⅱ anastomosis, 401 cases underwent Roux-en-Y anastomosis and 13 cases underwent residual stomach-esophagus anastomosis. The operation time, volume of intraoperative blood loss and cases with intraoperative blood transfusion were (221±51)minutes, (201±81)mL, 24 of 415 cases undergoing Da Vinci robotic radical gastrectomy, and (196±42)minutes, (232±76)mL, 75 of 981 cases undergoing laparoscopic radical gastrectomy, respectively. (2) Postoperative situations: the time to postoperative first flatus, time to postoperative initial liquid food intake and duration of postoperative hospital stay of the 1 396 patients were (3.0±1.0) days, (4.2±1.5) days and (9.0±3.8) days, respectively. Two hundred and ten of the 1 396 patients had postoperative complications including 170 cases with grade Ⅰ-Ⅱ complications and 40 cases with grade Ⅲ-Ⅴ complications. Eight of the 210 patients with postoperative complications died of serious complica-tions and the other 202 cases were cured after symptomatic treatment. Results of postoperative histopathological examination showed that there were 958 cases of adenocarcinoma, 220 cases of mucinous adenocarcinoma, and 218 cases of signet ring cell carcinoma. The number of lymph node harvested and the number of positive lymph node of the 1 396 patients were 26.0±8.3 and 3.6±0.9, respectively, and cases with the number of lymph node harvested ≥16 or <16 were 1 312 and 84. (3) Influencing factors for the number of lymph node harvested after radical gastrectomy for gastric cancer: results of univariate analysis showed that the operating surgeon, operation method, range of gastric resection, nerve invasion, degree of tumor invasion and tumor pathological N stage were related factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer ( χ2=13.167, 6.029, 15.686, 5.573, 9.402, 17.139, P<0.05). Results of multivariate analysis showed that the operating surgeon, operation method, range of gastric resection and tumor pathological N stage were independent factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer ( odds ratio=1.589, 2.018, 1.787, 0.267, 95% confidence interval as 1.221?2.068, 1.140?3.570, 1.066?2.994, 0.103?0.689, P<0.05). (4) Follow-up and survival: of the 1 396 patients, 1 256 cases were followed up for 2 to 70 months, with a median follow-up time of 27 months. The 3-year cumulative survival rate of the 1 256 cases was 70.2%. Conclusion:The operating surgeon, operation method, range of gastric resection and tumor pathological N stage are independent factors influencing the number of lymph node harvested after Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.