There are many problems in the use of Bupleurum medicinal materials such as confusion in variety, unclearness in origin and quality problems, e.g., adulteration of authentic Bupleurum and mixing of non-medicinal parts. Therefore, the quality of Chinese patent medicines containing Bupleurum chinense is variable, and it is necessary to establish targeted quality control methods. Based on the quality control methods of Bupleurum and its Chinese patent medicines, combined with the example of Xiaochaihu granules, this paper discussed the quality standard improvement and supplementary test methods of Bupleurum and its Chinese patent medicines, aiming to provide reference for the quality control, quality supervision and standardized production of Chinese patent medicines containing Bupleurum and promote the improvement of its intrinsic quality.

BACKGROUNDPercutaneous balloon pulmonary valvuloplasty (PBPV) is the preferred therapy for pulmonary valve stenosis (PVS). This study retrospectively reviewed recent PBPV outcomes in infants with PVS. The aim of this study was to evaluate factors associated with immediate therapeutic outcomes and restenosis during medium-term follow-up.

METHODSThe study included 158 infants with PVS who underwent PBPV from January 2009 to July 2015. Demographic characteristics and patient records were reviewed, including detailed hospitalization parameters, hemodynamic data before and immediately after balloon dilation, cineangiograms, and echocardiograms before PBPV and at each follow-up. All procedures were performed by more than two experienced operators.

RESULTSImmediately after balloon dilation, the pressure gradient across the pulmonary valve decreased from 73.09 ± 21.89 mmHg (range: 43-151 mmHg) to 24.49 ± 17.00 mmHg (range: 3-92 mmHg; P < 0.001) and the right ventricular systolic pressure decreased from 95.34 ± 23.44 mmHg (range: 60-174 mmHg) to 52.07 ± 18.89 mmHg (range: 22-134 mmHg; P < 0.001). Residual transvalvular pressure gradients of 67.31 ± 15.19 mmHg (range: 50-92 mmHg) were found in 8.2% of patients, indicating poor therapeutic effects; 6.4% of patients had variable-staged restenosis at follow-up and 3.8% underwent reintervention by balloon dilation or surgical repairs. Further analysis demonstrated that the balloon/annulus ratio showed statistically significant differences (P < 0.05) among groups with different therapeutic effects and between the restenosis and no-stenosis groups. Binary logistic regression analysis further revealed that higher balloon/annulus ratio (odds ratio: 0.005, 95% confidence interval: 0-0.39) was an independent protective factor for restenosis. The rate of severe complications was 1.9%.

CONCLUSIONSPBPV is a definitive therapy for infants with PVS based on its effectiveness, feasibility, and safety. Restenosis upon medium-term follow-up is relatively rare.

OBJECTIVETo compare the clinical efficacy of trapezoid pad coordinate with small splint fixation treatment with plaster slab fixation treatment for comminuted Colles fracture.

METHODSFrom October 2010 to March 2012,80 outpatients with comminuted Colles fracture were divided into two groups. There were 40 patients in trapezoid pad splint fixation treatment group and 40 patients in pipe type plaster control group. There were 13 males and 27 females in trapezoid pad splint fixation treatment group,with an average age of (62.1 +/- 19.2) years old. And there were 15 males and 25 females in pipe type plaster control group,with an average age of (60.2 +/- 19.5) years old. After treated with manipulative reduction,the fractures were fixed with pipe plaster in the control group, and were fixed with trapezoid pad joint by small splint in the treatment group. The patients in both groups were regularly taken X-ray recheck and changed dressings to obtain the clinical healing. Patients were guided to do functional exercise after splints were taken off. The therapeutic effects were evaluated according to Gartland-Werlley wrist score when splints taken off and after 2 months.

RESULTSAccording to wrist score, the average scores in the treatment group were (8.1 +/- 2.8) when splints taken off and (5.3 +/- 4.5) after 2 months. And the average scores in the control group were (10.3 +/- 2.6) when splints taken off and (8.4 +/- 5.8) after 2 months. The score in the treatment group was higher than that of control group. The average shortened lengths of radius were (4.8 + 1.7) mm in the treatment group and (8.2 +/- 2.1) mm in the control group. The shortened length of control group was larger than that of treatment group.

CONCLUSIONTrapezoid pad coordinated with small splint fixation is better than traditional pipe type plaster for treating comminuted Colles fracture.

Adult ; Aged ; Case-Control Studies ; Casts, Surgical ; Colles' Fracture ; surgery ; Female ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Splints

Objective    To investigate the effectiveness and safety of totally endoscopic transmitral myectomy (TETM) for hypertrophic obstructive cardiomyopathy (HOCM), comparing with traditional sternotomy modified Morrow procedure (SMMP). Methods    Thirty-eight patients with HOCM who needed surgical intervention were selected from our hospital in 2019, including 14 males and 24 females, with an average age of 56 (44-68) years. According to the operation method, they were divided into a TETM group (n=18) and a SMMP group (n=20). Appropriate patients  were screened by propensity matching scores. Finally, the clinical data of two matched groups were compared and

The choice of friction interface has always been a controversial topic in hip arthroplasty. Although the metal-on-metal (MoM) interface has gradually faded out of our vision, its revision is a clinical difficulty. Adverse reactions to metal debris (ARMD) is the most common indication for MoM hip arthroplasty revision, and the clinical results of hip arthroplasty due to ARMD are not satisfactory. At present, the indications and suggestions for revision of ARMD are not uniform. In this article, the clinical diagnosis, indications of revision, risk factors of prognosis, intraoperative suggestions and reasons for revision of ARMD were summarized. This article briefly introduces the diagnosis and treatment strategies and precautions of hip arthroplasty due to ARMD, in order to provide reference for such patients in clinical practice.
Arthroplasty, Replacement, Hip/adverse effects* ; Hip Prosthesis/adverse effects* ; Humans ; Metal-on-Metal Joint Prostheses/adverse effects* ; Prosthesis Design ; Prosthesis Failure ; Reoperation

Translational medicine has been on the rise for 20 years as a new model of biomedical research,which plays a positive role in narrowing the gap between basic research and clinical medicine and in development of medical sciences.This paper traced back the milestones of translational medicine,and analyzed the hurdles for China to develop translational medicine,namely the organization system,management model and benefit sharing.On such basis,the authors recommended on the development and strategy,especially in clinical medical institutions in China.

OBJECTIVE: To explore the influencing factors of occupational stress from occupational hazards in employees of a power grid enterprise. METHODS: A total of 972 employees from 3 substations and 1 power dispatch center of a power grid enterprise were selected as research subjects by the cluster sampling method. The Chinese version of the Job Content Questionnaire was used to evaluate the occupational stress using the job demand control(JDC) model. The influence of occupational hazards on occupational stress was analyzed. RESULTS: The median, the 25 th and 75 th percentile scores [M(P_(25), P_(75))] of the 972 research subjects on job demand, job control, and social support dimensions of JDC model occupational stress were 14(12, 15), 25(23, 26), 24(23, 24), respectively. The M(P_(25), P_(75)) of the demand/control(D/C) ratio was 0.99(0.89, 1.13). The incidence of occupational stress was 48.4%(470/972) by the JDC model. The job demand dimension scores, D/C ratios, and incidence of occupational stress by JDC model were higher in employees exposed to electromagnetic radiation, high temperature, high altitude, and visual display terminal(VDT) than in those employees not exposed to the above factors(all P<0.05). The results of multivariate logistic regression analysis showed that the risk of occupational stress increased in those employees exposed to high temperature, high altitude and VDT(all P<0.05) after excluding the influence of confounding factors such as age, length of service, monthly income and exercise. The odds ratio and 95% confidence intervals were 1.91(1.43-2.54) and 1.67(1.26-2.21), respectively. CONCLUSION: The level of occupational stress among employees in power grid enterprise is relatively high by JDC model. High-temperature, high-altitude and VDT operation are the main risk factors of occupational stress by JDC model.

]复发和转移是影响鼻咽癌患者预后和生存质量的主要原因。目前临床上主要使用基于解剖学的TNM分期标准，并不能 准确反映患者的预后情况，因此需要开发新的更为精准的鼻咽癌预后判断标准。通过对鼻咽癌发病机制的研究，分子标志物在 鼻咽癌预后过程的预测价值日益引起关注。本文总结了近年来在鼻咽癌增殖、生存和侵袭转移等方面的研究进展，以及在这些 研究过程中发现的相关分子标志物和它们在临床预后评估中的作用，综合分析这些分子标志物差异性表达与临床患者生存之间 的相关性，证明了这些分子标志物在评估患者预后中的潜在价值。随着对鼻咽癌发病机制研究的深入，将会发现更多有价值的 分子标志物，这为建立更为精准的鼻咽癌预后评估方法提供了可能。

Objective:To investigate the difference of isokinetic angle-specific moment curves between anterior cruciate ligament (ACL)-injured patients with and without patellofemoral cartilage injury (PFCI). Methods:A retrospective analysis was performed on patients underwent knee arthroscopy and isokinetic muscle strength testing before surgery from September, 2018 to September, 2019. Seventeen ACL-injured patients with PFCI and 17 ACL-injured patients without PFCI who matched in age, sex and meniscus injury were selected. Before arthroscopy, isometric and isokinetic strength of knee flexion and extension at velocity of 180°/s and 60°/s was tested by isokinetic dynamometer. Normalized torque-angle curves (torque/body mass) were generated in steps of 1° and the differences in angle-specific moment curves between two groups were compared. Results:At 180°/s, there was no significant difference in flexion isokinetic torque both healthy side and affected side between two groups (P >0.05); and no difference in extension torque of the healthy side (P >0.05), however, there was significant difference in extension torque of the affected side at 88° to 90° between two groups (t > 2.102, P <0.05). At 60°/s, there was significant difference in flexion torque of the healthy side at 62° to 82° between two groups (|t| >2.056, P <0.05), and no significant difference was found in flexion torque of the affected side (P >0.05), nor in extension torque of both sides between two groups (P > 0.05). A curve change was found at the beginning of the flexion and extension isokinetic moment curves at the velocity of 180°/s. The isometric knee extension torque was significantly different in the affected side between two groups (t = 2.858, P < 0.01), and no difference was found in isometric knee flexion torque in the affected side as well as both extension and flexion torques in the healthy side between two groups (t < 1.905, P > 0.05). Conclusion:The lower the isokinetic speed, the more significant the difference of strength is between ACL-injury patients with and without PFCI. High speed exercise is recommended for ACL-injured patients with PFCI.

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.