A clinical emergency skill contest using emergency care simulator (ECS) was carried out　on May 2011.Total 30 family physicians in 10 teams from Shenzhen community health centers participated in　the contest.The performance and the scores of each item were analyzed.The overall score was 61.3 ± 11.9.The average score for general treatment was 33.0 ± 6.9 with a score rate of 66％ (33/50) ; the average　score for cardiopulmonary resuscitation was 23.2 ± 7.2 with a score rate of 57.5％ (23/40) ; the average　team score was lowest (5.0 ± 1.1 ) with a score rate of 50.0％ (5/10).The results indicate that family　physicians should strengthen clinical skill training of emergency care,particularly in on-site response and　teamwork.

The chemical constituents and their biological activities of simaroubaceae plants were reviewed in the paper. The chemical constituents of simaroubaceae plants are alkaloids and terpenoids, and the biological activities are anti-tumor, insecticidal, antihypertensive, anti-inflammatory, antibacterial and anti-malaria and so on. The review alms to provide references for the comprehen-sive development and utilization of simaroubaceae plants.

It was reported that a complete antifertility action of alpha-chlorohydrin in combination with glycidol in male rats after a daily oral dose of 5mg/kg and 75mg/kg respectively for two days. Simultaneously some ultrastructural changes including mitochondrial swelling, atrophy of Golgi complex, decreasing in pinocytotic vesicles and stereocilia were found in principal cells of epididymis within 3 days after medication.In this experiment the animals received 3, 6 and 9 courses of treatment respectively, each course included two days of administration with a daily dose mentioned above and eight days of cessation of medication.The specimens of initial segment of epididymis, liver and kidney were taken at the end of 3 rd, 6 th and 9th courses of treatment for electron microscopy.The principal cells of initial segment of epididymis revealed a normal feature at the end of 3 rd and 9 th course of treatment. But at the end of 6 th course of treatment, the atrophy of Golgi complex and the decrease in stereocilia and pinocytotic vesicles were found in some principal cells.Any ultrastructural changs of sperms in the initial segment were not found by electron microscope.There was also mitochondrial changes with striking increase in the density of the matrix and reduction of size in some liver cells at the end of 6 th course of treatment, but not at the end of 3 rd or 9 th course of treatment. The epithelial cells of nephron in all the specimens revealed a normal ultrastructural feature.The results suggest that the ultrastructural changes of the principal cells and the liver cells induced by the mixture of the drugs could be recovered at the end of treatments.

Objective: To observe the effects of needles with different diameters on the gastrointestinal function in mice. Methods: Eighteen Kunming mice were randomly divided into group of 0.25 mm needle, group of 0.35 mm needle, and control group. The acupoint of Zusanli (ST 36) was needled once a day for 5 days. The effects of needles with different diameters were observed by measuring the distance of the carbon moved in the intestine. Results: The distance of the carbon moved in the intestine was longer in the acupuncture group than in the control group (P<0.05), and it was longer in the group of 0.35 mm needle than in the group of 0.30 mm needle, there was no significant difference (P>0.05). Conclusion: Acupuncture treatment can enhance the peristalsis function of stomach and intestine in mice. The diameter of needle has no effect on the gastrointestinal function.

OBJECTIVE:To evaluate the clinical efficacy of liraglutide and insulin glargine in the treatment of type 2 diabetes mellitus (T2DM) and conduct pharmacoeconomic analysis, and to provide economical and reasonable T2DM treatment plan. METHODS:80 T2DM patients were randomized into liraglutide group and insulin glargine group,with 40 cases in each group. Both groups were given Metformin hydrochloride sustained-release tablet orally 0.5-2.0 g/d,and diabetes mellitus diet and sport training guide after oral antidiabetic drug withdrawal of previous treatment plan. Liraglutide group was given Liraglutide injection hypodermically,0.6-1.2 mg,qd;insulin glargine group was given insulin glargine hypodermically at 22 o’clock,initial dose of 0.2 IU/(kg·d),adjusted according to the levels of PG,FBG,nocturnal blood glucose level till FBG≤7 mmo1/L and 2 h PG ≤10 mmol/L in both group. Treatment course of 2 groups lasted for 12 weeks. The changes of FBG,2 h PG,HbA1c and BMI were ob-served in 2 groups before and after treatment. 2 therapy plans were evaluated and compared by cost-minimization analysis. RE-SULTS:After treatment,the levels of FBG,2 h PG and HbA1c decreased significantly in 2 groups,compared to before treatment, with statistical significance (P<0.05),but there was no statistical significant difference between 2 groups (P>0.05). After treat-ment,BMI of liraglutide group decreased significantly compared with before treatment and insulin glargine group,with statistical significance (P<0.05). There was no statistical significant difference in BMI of insulin glargine group before and after treatment (P>0.05). Cost-minimization analysis showed that the cost of insulin glargine group in reducing FBG,2 h PG and HbA1c were less than liraglutide group,but were more than liraglutide group in reducing BMI. Sensitivity analysis demonstrated the stability and reliability of cost-minimization analysis. CONCLUSIONS:Lira-glutide and insulin glargine have the same clinical efficacy,but insulin glargine need lower cost in blood glucose control,and liraglutide is better therapy plan for body weight control.

Combined effects of ?-chlorohydrin and glycidol on the ultrastructure of theinitial segment and the tail region of the rat epididymis have been studied by ultra-thin sections under electronmicroscope.Individual effects of the both drugs on thesame tissues were also examined simultaneously.The major results are as follows.1.Numbers of swollen and degenerated mitochondria were observed in principalcells,clear cells,apical cells and basal cells of epididymal epithelium,as well as insmooth muscle cells of the ductus epididymidis and in endothelial cells of the capil-laries in epididymal interstitium during a period of 3～30 days after administrationof low dose of ?-chlorohydrin combined with glycidol(5 mg ?-chlorohydrin plus75mg glycidol/kg/day?2),which previously has been proved to be effective inmale rat antifertility.Additionally,Golgi vacuoles,pinocytotic vesicles,multivesicularbodies,stereocilia and smooth endoplasmic reticulum in the apical cytoplasm of someprincipal cells occasionally were found to decrease in number.No Morphologicalchanges of the nuclei were found in these affected cells.The number of morphologi-cally unchanged mitochondria appears to become more with extended time after drugswithdrawal.2.In the group treated with the large combined dose of the drugs(20 mg ?-chlorohydrin plus 100 mg glycidol/kg/day?2),apart from the changes mentionedabove,necrosis and exfoliation of some epididymal epithelial cells could be found.Some lesions of the sperm,such as the destruction of the cytoplasmic membrane,swelling of mitochondria and pyknosis of nucleus were present in a few specimenstaken from this group.3.Effects similiar to that of the combined use of the drugs were also found ingroups using ?-chlorohydrin or glycidol alone,but a less degree of lesions revealed.These observations suggested that the antifertile effects of ?-chlorohydrin andglycidol either used in combination or alone could result injury of mitochondria inepididymal epithelial cells,which should lead to the decrease of the function ofepididymis,hence to interfere with the maturation of the sperm in it.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

Objective:To assess the clinical effectiveness and safety of Runing granule for hyperplasia of mammary gland.Methods:The databases such as the CNKI, Wanfang Data, VIP, CBM, Cochrane Library, Embase, PubMed and Web of Science are searched from the date of their establishment to June 2020. The main outcome measures were effective rate and incidence of adverse events. All randomized control trial (RCT) about the clinical effectiveness and safety of Runing granule single (single group) or combined with other treatment (combined group)/ other treatment (control group) for hyperplasia of mammary gland were included. Endnote software was used to manage literature, Excel software was used to extract data, quality assessment was conducted according to the methods of Cochrane Reviewers′ Handbook 5.1 recommend by the Cochrane Collaboration and Revman 5.3 software was used to perform Meta-analysis.Results:Twelve RCT were included with total 2 447 patients. In terms of efficiency, Meta-analysis showed single group was better than control group ( RR=1.17, 95% CI: 1.00-1.36, P=0.04), combined group was better than control group ( RR=1.35, 95% CI: 1.10-1.67, P=0.005). In terms of adverse event rate, single group was lower than control group ( RR=0.18, 95% CI: 0.09-0.34, P<0.01), combined group was better than control group( RR=0.33, 95% CI: 0.20-0.56, P<0.01). Conclusion:The usage of Runing granule single or combined with other treatment in the treatment of hyperplasia of mammary gland is more effective and the adverse reaction is lower.

ObjectiveTo summarize the current situation, hot spots and frontiers of the application of functional near-infrared spectroscopy (fNIRS) in rehabilitation in recent ten years. MethodsLiterature related to the application of fNIRS in rehabilitation was retrieved from the core collection of Web of Science from January, 2003 to December, 2022, and the visualized analysis was performed by CiteSpace 6.1.R6 software. ResultsA total of 828 literatures were included. The annual publication volume was on the rise. The most prolific author was LI Zengyong. The most published country was the United States. And the most published institution was Karolinska Institute. Hot keywords included children, stroke, activation, quality of life, cerebral palsy, etc. The hot keywords of bursting intensity included early intervention, speech perception, cerebral palsy, plasticity, spinal cord injury, physical therapy, visual feedback, Parkinson's disease, etc. Cluster analysis suggested that in the past decade, the application of fNIRS in rehabilitation involved physical therapy, speech therapy, occupational therapy, pre-rehabilitation and early rehabilitation of surgery, mainly focusing on six themes: the rehabilitation of motor dysfunction after stroke, cognitive impairment, hearing and speech dysfunction, children with cerebral palsy, cardiopulmonary function monitoring in severe diseases and long-term nursing of chronic diseases. Among them, the application of fNIRS in neurological rehabilitation of stroke patients occupied a large proportion, which might be the current research hot spot and trend. ConclusionThe application of fNIRS in rehabilitation is on the rise. In the future, more attention should be paid to the application of fNIRS in the study of the injury and recovery mechanism of neurological disorders, especially the effects of various rehabilitation interventions on cortical plasticity and the etiology of neurological disorders.

Mycobacterium tuberculosis (MTB) utilizes multiple mechanisms to obtain antibiotic resistance during the treatment of infections. In addition, the biofilms, secreted by MTB, can further protect the latter from the contact with drug molecules and immune cells. These self-defending mechanisms lay a formidable challenge to develop effective therapeutic agents against chronic and recurring antibiotic-tolerant MTB infections. Although several inexpensive and effective drugs (isoniazid, rifampicin, pyrazinamide and ethambutol) have been discovered for the treatment regimen, MTB continues to cause considerable morbidity and mortality worldwide. Antibiotic resistance and tolerance remain major global issues, and innovative therapeutic strategies are urgently needed to address the challenges associated with pathogenic bacteria. Gratifyingly, the cell wall synthesis of tubercle bacilli requires the participation of many enzymes which exclusively exist in prokaryotic organisms. These enzymes, absent in human hepatocytes, are recognized as promising targets to develop anti-tuberculosis drug. In this paper, we discussed the critical roles of potential drug targets in regulating cell wall synthesis of MTB. And also, we systematically reviewed the advanced development of novel bioactive compounds or drug leads for inhibition of cell wall synthesis, including their discovery, chemical modification, in vitro and in vivo evaluation.