AIM: To observe the clinical effecacy of Aidi Injection (Radix Ginseng, Radix Astragali, Mylabris, Radix et Caulis Acanthopanacis Senticosi) combined with chemotherapy in the treatment of malignant advanced tumor. METHODS: Patientes (106 cases) with advanced malignant tumor were randomized into two groups: therapeutic group (56 cases) and control group (50 cases). The therapeutic group:the chemotherapy combined with Aidi Injection (60～80mL), once a day, for 10 days. The control group:the chemotherapy alone. Two groups mainly used PTX、DDP、EPI、5 FU、VP16 etc for chemotherapy. RESULTS: The therapeutic group has different degrees of improvement in life quality, short term efficacy, leukooytai drop and T cellular subfamily, etc. There was markedly difference between the therapeutic group and the control group ( P

BACKGROUND: To determine the non-or collapsed osteonecrosis of the femoral head (ONFH) and degree of collapse, can help surgeons design reasonable treatment strategy for patients with ONFH. In China, articular cartilage collapse less than or greater than 2 mm, is a basis for choosing palliative surgery or hip replacement. However, the measurement of collapsed ONFH before replacement has not yet been confirmed. OBJECTIVE: To predict the collapse of femoral head before replacement by CT and X-ray examinations, and to compare with the intraoperative excised femoral head specimens.METHODS: This was a single-center, open-label and diagnostic trial, which was finished at the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China. Eighty-six patients with unilateral ONFH undergoing total hip replacement were recruited, and allocated into three groups, such as X-ray, CT and specimen groups. The X-ray group underwent X-ray examination at anteroposterior pelvic (bilateral hips) at 1 week before surgery, the CT group received CT scan at bilateral hips at 1 week before surgery, and the specimen group was subjected to the removal of affected femoral head, and then directly measured using ruler and vernier caliper. Primary outcome was the sensitivity of thesethree methods for measuring collapsed femoral head. Secondary outcomes were the specificity, positive predictive value,negative predictive value, positive likelihood ratio, and negative likelihood ratio of these three methods for the diagnosisof collapsed femoral head and the diagnostic accuracy; the diagnostic consistence of CT and X-ray examinations; the height of the lateral, middle and external femoral head measured by three methods. The study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University, China, and will be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be obtained from all participants prior to the trial. DISCUSSION: In this study, the height of femoral head was measured and analyzed in all-dimensional and multi-anglemanner based on intraoperative removed specimens, so as to make an accurate prediction for collapsed femoral head, thus providing imaging reference for surgeons prior to choosing an appropriate operative scheme

Objective To improve the accuracy of medical students to put on and off the protective equipment with mind map joint microteaching approach teaching method. Method 90 medical students in clinical practice were randomly selected for teaching objects and divided into two groups, each group having 45 people. The control group used the traditional teaching while the experimental group was trained by mind map joint microteaching approach teaching method. And then, the examination table was conducted to each group and the assessment accuracy of the skills assessment results and excellent rates of the two groups were compared. Statistical analysis was performed by χ2 test. Results The average score of students of the experiment group in the whole set of putting on and off protective equipment and skills points assessment were higher than the control group, and the difference was statistically significant [(91.40±6.61) vs. (80.09± 6.28), P=0.001; (12.13±2.26) vs. (8.78±2.45), P=0.001]. The excellent rate of students of the experiment group in putting on and off protective equipment assessment and skills points examination was higher than the control group, and the difference was statistically significant (80%vs. 35%, P=0.001;71%vs. 13%, P=0.001). Conclusion Using innovative mind map joint microteaching approach teaching method can im-prove the medical students' operating skills and excellent rate s in putting on and off the protective equip-ment, and at the same time enhance their learning interest and professional protection level.

ObjectiveTo explore the bone anabolic effects after a single local injection of simvastatin into femoral cavities of osteoporotic rats.MethodsThirty-six female SD rats(3 months old,body weight 250-300 g) were ovariectomized(OVX) and low-calcium-diet fed for 3 months,OVX rats were randomized into 3 groups(n=12).Left femurs of group A,B and C were injected with 0,5 and 10 mg simvastatin,respectively.Half of the rats in each group were randomly euthanized separately 1 and 5 months after simvastatin injection.Left femurs were taken out for bone mineral density (BMD) assessment with dual energy X-ray absorptiometry,bone histomorphometic changes were analysized by Micro-CT,and two kinds of biomechanical tests were used to evaluate the osteogenic effects.ResultsOne and five months after injection,BMD in mid-diaphysis significantly increased in simvastatin-injected groups compared to the control group.For Micro-CT analysis,significant increase in total bone volume/total tissue volume,cortical wall thickness,trabecular thickness,trabecular number,and a significant decrease in trabecular spacing were observed in simvastatin-injected groups compared to the control group.For both biomechanics (the three-pointbreaking test of condyles and axial compressive testing of proximal femur),the values were significantly higher in simvastatin-injected groups than the control group.ConclusionLocal simvastatin treatment showed a positive effect on improving mechanical strength,structure of osteopenic femurs and BMD.Our findings may provide a new strategy for the prevention and treatment of osteoporosis,especially for osteoporotic fractures.

Objective To study the mechanism of Bushen Granule (G ranule for rein forcing the kidney) for the treatment of chronic aplastic anemia (CAA). Methods The CAA patients were divided into the herbal group (60 cases) treated mainly by Bu shen Granule with syndrome differentiation and the Cyclosporin A group (16 cases ) tr eated mainly by Cyclosporin A for 6 months. The healthy control group consisting of 20 healthy subjects was set up. The expressions of CD3 +, CD3+CD28+, and CD3+CD95+ of the healthy control groups were compared with the herbal group and the Cyclosporin A group. Results The expressions of CD3 +, CD3+CD28+, and CD3+CD9 5+ of the CAA groups were higher than those of the healthy control group (P

Objective: To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies. Methods: By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan. Results: Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background ( χ 2=50.73-203.36, P < 0.05 ). The implementation of regular public health emergency related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%). Conclusion Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.

Objective To analyze the genotypes of Neisseria gonorrhoeae ( N. gonorrhoeae) epi-demic strains in Wenzhou, eastern China, and to study the mechanism of tetracycline resistance in these strains. Methods A total of 77 N. gonorrhoeae strains were isolated from patients with gonorrhea. Antimi-crobial susceptibility of these strains to penicillin, tetracycline, ciprofloxacin, spectinomycin, ceftriaxone and azithromycin was analyzed using E-test. PCR and DNA sequencing were used to detect the genes associ-ated with tetracycline resistance, such as Tet-M, mtrR promoter region and mtrR coding region. N. gonor-rhoeae multi-antigen sequence typing ( NG-MAST) and multilocus sequence typing ( MLST) were used to determine the molecular characteristics of all clinical isolates and tetracycline-resistant isolates, respectively. Results Among the 77 N. gonorrhoeae isolates, 74 (96. 10％), 27 (35. 06％) ,70 (90. 91％) and 15 (19. 48％) were resistant to penicillin, tetracycline, ciprofloxacin and azithromycin, respectively. All tested isolates were susceptible to spectinomycin and ceftriaxone. Nineteen isolates were resistant to tetracycline and all of them carried Tet-M gene. Among them, 17 had one deletion mutation of base A in mtrR promoter region and three had G45D mutation in mtrR coding region. NG-MAST classified the 19 tetracycline-resistant isolates into 11 different sequence types (ST). ST14781, ST1766 and ST1866 each accounted for 15. 79％(three strains). Two ST (10. 52％, 2/19) found in the present study had not been reported previously in the NG-MAST database. MLST showed the 19 tetracycline-resistant isolates belonged to 12 different STs, in which ST10899 accounted for 26. 32％ (five strains) and ST1600 accounted for 15. 79％ (three strains). Conclusions Mutations in mtrR promoter region and carrying Tet-M gene were associated with tetracycline resistance in N. gonorrhoeae. Clinical strains isolated in Wenzhou showed considerable molecular diversity. Measures should be implemented to monitor the spread of NG-MAST ST1766 and MLST ST1600 N. gonor-rhoeae clones with high resistance to tetracycline in Wenzhou.

Objective:To identify the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip surgery.Methods:The medical records of elderly patients, aged ≥ 65 yr, of American Society of Anesthesiologists (ASA) physical statusⅠ-Ⅳ, who underwent hip surgery from June 2013 to May 2019, were retrospectively collected.The patients′ sex, age, body weight, preoperative comorbidities, history of smoking and alcohol, results of the last laboratory test before surgery; mode of anesthesia, intraoperative medication, body temperature monitoring, fluid intake and output, operation time, anesthesia time; postoperative PPCs and postoperative nausea and vomiting, requirement for rescue analgesia, length of hospital stay, and perioperative blood transfusion were all collected.According to the occurrence of PPCs, patients were divided into PPCs group and non-PPCs group.Multivariable logistic regression was used to determine the risk factors for PPCs.Results:A total of 1 204 patients were finally enrolled in this study, 75 patients developed PPCs, and the incidence was 6.22%.The results of multivariate logistic regression showed that ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion were risk factors for PPCs, and general anesthesia combined with nerve block was a protective factor for PPCs in elderly patients undergoing hip surgery ( P<0.05). Conclusions:ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion are risk factors for PPCs, and general anesthesia combined with nerve block is a protective factor for PPCs in elderly patients undergoing hip surgery.

The healthcare-associated infections (HAI) cases monitoring system, automatic access to the medical record homepage and HAI early warning application of untreated early warning information interception and other means of information are introduced into the hospital. These means ensure the accuracy and integrity of the medical record homepage diagnostic and statistical data base information, and HAI consistency as well. Closed loop management of HAI cases provides accurate information for the hospital business intelligence platform, serving hospital administration and clinical management with accurate data. Hence precise decision-making basis can be provided for the improvement of medical quality of the hospital.

Objective To study the association between reasons for smoking and results related to successful smoking cessation. Methods A community-based case-control study was conducted with 642 male adults recognized as successful spontaneous smoking quitters being the subject cases while another 700 male adults who had failed to quit smoking were served as the controls. Russell Reason for Smoking Questionnaire(RRSQ)was used to investigate the reasons for smoking. Dominance logistic regression was performed to determine the relative importance of reasons for starting smoking and the endpoint of successful quit smoking. Results After adjusting the potential confounders of age,age of smoking initiation,marital status,profession,and education,the adjusted means of sedative and stimulation of RRSQ in the successful quitters were significant lower than that in the failed quitters. Results from the dominance logistic regression showed that the first two important factors for smoking cessation were sedative and stimulation of RRSQ,followed by psychological image,automatic,hand-mouth activity,indulgence,and addiction. Conclusion This study demonstrated that factors as dependence-addiction showed more important impacts than the social-psychological ones on the endpoint of successful smoking cessation.