Objective To observe the analgesia effect of combination of continuous femoral nerve block and oral analgesics after total knee arthroplasty and the impact on early rehabilitation of knee.Methods Sixty patients scheduled for unilateral total knee arthroplasty were randomly divided into two groups.One group was the multimodal analgesia group (group M)and the other was patient controlled intravenous analgesia group (PCIA)(group Ⅰ),30 patients in each group.In group M, patients were given celecoxib (200 mg,bid)and oxycodone (10 mg,bid)two days before operation, then received continuous femoral nerve block followed by oral acetaminophen (100 mg,tid)and oxyc-odone (20 mg,bid)three days after operation.In group I,patients took no medicine before operation and only received PCIA after operation.The two groups were compared with postoperative visual ana-logue scale(VAS)scores at 6,12,24,48 h at rest,during active training and continuous passive movement,range of motion of the knee joint during active training and continuous passive movement, the first time of ambulation,length of hospital stay,range of motion of the knee joint at hospital dis-charge and the incidence of complications.Intravenous dezocine 5 mg was given when VAS score was higher than 5,which was recorded.Results Compared with group Ⅰ,the VAS scores at rest,during active and continuous passive movement at postoperative 6,12,24,48 and 72 h in group M were de-creased significantly (P <0.05).The range of motion of the knee joint during active training and con-tinuous passive movement at postoperative 24,48 and 72 h in group M was increased significantly(P<0.05).The first time of ambulation(2.5±0.8)d and length of hospital stay(9.1±2.3)d in group M were shorter significantly than the first time of ambulation (3.3 ±0.7)d and length of hospital stay (10.8±2.0)d in group I (P <0.05 ).The range of motion of the knee joint(95.6 ± 1 7.2)°in group M at hospital discharge was greater significantly than the range of motion of the knee joint (82.5± 1 5.2 )° in group I (P < 0.05 ).The incidence of nausea and vomiting (3.3%),uroschesis (6.7%)in group M was lower significantly than the incidence of nausea and vomiting (30.0%), uroschesis (26.7%)(P < 0.05 ).Additional use dezocine (3.3%)was lower significantly than additional use dezocine (40.0%)(P <0.05).Conclusion Compared to patient controlled intravenous analgesia,combination of continuous femoral nerve block and oral analgesics can effectively alleviate postoperative pain in patients undergoing total knee arthroplasty,which is beneficial to early postop-erative knee function recovery.

Objective To observe the effect of blood feeding and plasmodium yoelii infection on the transcript abundance of ribosomal protein S7 from Anopheles dirus hemocyte Methods Anopheles dirus of 3～5 days old were divided into normal group (N), blood feeding group(B) and Plasmodium yoelii infection group(I) Hemocytes of 50 Anopheles dirus from each group were collected by centrifuge method on days 1, 2, 3, 4, 7 and 11 after blood feeding, respectively Then, all hemocyte samples were used for total RNA isolation and analyzed by RT PCR Finally, the same volume(10 ?l) of all the PCR products from each group was used for agarose gel electrophoresis and the data obtained were analyzed statistically Results There was no significant difference in ribosomal protein S7 signal between the three groups Conclusion Similar to Anopheles gambiae and human rpS7, Anopheles dirus rpS7 might be also used as an internal control for the studies of the role of Anopheles dirus related immune factors in attacking Plasmodium infection

Objective To study the appearance of MR diffusion weighted imaging in early stages of cartilage degeneration and to detect its values. Methods In 20 goat left knees, intra- articular injection of 5 units of papain was performed causing a loss of cartilage proteoglycan. Twenty right knees were used as control group. MR diffusion weighted imaging was performed at 24 hours after intra-articular injection of papain. ADC of each part of articular cartilage was measured and compared with each other. The proteoglycan content was measured biochemically and histochemicaUy. Routine MRI and DWI were performed in 100 patients with osteoarthritis and 20 healthy people. The ADC of each interested part of articular cartilage was measured and compared with each other. Results In experimental control group, the ADCav of articular cartilage was (14.2±2.3)×10-4 mm2/s. In early stages of cartilage degeneration group, the ADCav of articular cartilage was (17.5±4.2) × 10-4 mm2/s. The ADCav of the control group was lower than that of the early stages of cartilage degeneration group (t = 2.709 ; P = 0.016) . The proteloglyean content of articular cartilage was 4.22×10<'6> μg/kg in control group, and 0.82×10<'6>μg/kg in experimental group at 24 hours after injection of papain. The difference between control group and experimental group was significant (t = 2.705, P = 0.018). In healthy people, the ADCav of articular cartilage was (7.6±2. 2) × 10-4 mm2/s. In osteoarthritis group, the ADCav of articular cartilage was (10.3±4. 2) × 10-4 mm2/s. The ADCav in the healthy group was significantly lower than that in the osteoarthritis group (t = 2.609, P = 0.014). Conclusion DWI is an useful method in detecting early stages of cartilage degeneration which can not be showed on routine sequences.

Objective To analyze the laboratory diagnosis results and epidemiological characteristics of imported malaria cases in Chongqing Municipality in 2015. Methods According to the Standard Operating Procedures of Malaria Diagnosis Ref-erence Laboratory Manual,all the blood samples collected from the imported malaria patients were detected by microscopy, RDT and nest PCR. Meanwhile,the epidemiological data of the malaria cases were collected from the Parasitic Diseases Informa-tion Management System and analyzed. Results Totally 31 cases of imported malaria were reported in Chonqing Municipality in 2015,among which,there were 2 vivax malaria cases(6.45%),23 falciparum malaria cases(74.19%),5 ovale malaria cas-es(16.13%),1 malariae malaria case(3.22%). For the 5 ovale cases,three of them were confirmed as Plasmodium ovale wal-likeri infection. Among all the cases,30 cases(96.77%)were from African countries,1(3.33%)was from Southeast Asia. Thir-ty patients were male,and 1 was female. All the patients were aged from 23-61 years. There was no obvious seasonality in the case distribution. Both the medians of duration from malaria attack to first visiting a doctor and from first visiting a doctor to diag-nosis were 2 days. The medical care units that the patients first visited were mainly county-level units,while those that made the diagnosis were mainly provincial level institutes. Conclusions All the malaria cases in Chongqing in 2015 are imported,no lo-cal cases have been found,which suggests that this municipality still maintain the malaria elimination state. However,the moni-toring and management of imported malaria cases as well as the training on malaria control for related medical staff still need to be strengthened.

Objective To investigate demographic and clinical features of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese patients.Methods Data of 45 HNPCC pedigrees diagnosed in accordance with Armsterdam I and Armsterdam Ⅱ Criteria were collected and analyzed.Results In 264 patients, 305 malignant neoplasms were found.The median age of confirmed diagnosis of HNPCC was 50 years.Out of the 305 primary cancer foci, 180 were colonic cancers (59%), 125 were extracolonic cancer (41%) with carcinoma of the lung, endometrium and stomach accounting for 24.0% (30/125), 14.4% (18/125), and 12.0% (15/125) respectively.Conclusion HNPCC is characterized by early vertical transmission, with extracolonic cancer, and synchronous multiple and/or metachronous multiple primary cancers as common clinical features. Carcinoma of the lung, endometrium and stomach are among the most common extracolonic malignancies.

Objective To study the impacts of alcohol dependence on the anticonvulsant effect of diazepam. Meth?ods Kunming mice (n=36) were divided into 3 groups (n=12 in each group), Alcohol Dependence Group(A group), Diaze?pam Group(D group)and Normal Saline Group(N group). A group received an intraperitoneal injection with a 0.2 mL dose of 0.8%alcohol in NS (normal saline) , while both D and N group received an injection with a 0.2 mL dose of NS without alco?hol , twice a day. Mice’s autonomic activities were monitored every day. After 7 days, the electroconvulsive experiment was performed. Both A and D group were given a weight-based dose of 0.05 mL/10 g of 0.05%diazepam via intraperitoneal injec? tion, while N group was given a 0.05 mL/10 g dose of NS. Before administration and after 15, 30, 60 min of administration, the convulsion threshold of each group was measured. Results The count of autonomic activity of mice in A group was less than that of mice in D and N group during the 2nd day to 6th day(P<0.05). On the 1st and 7th day, the difference of the count of autonomic activity of mice between A group and the other two groups was not statistically significant(P>0.05). The convulsion threshold of mice in A group was higher than that of mice in D and N group before administration(P<0.05). Af?ter administration, the convulsion threshold of mice in N group didn’t show statistically significant difference from that of mice before administration(P>0.05). After 15 min of administration, the convulsion threshold of mice in D group was high?er than that of mice in A and N group(P<0.05), while the convulsion threshold of mice in A group was higher than that of mice in N group(P<0.05). After 30 min and 60 min of administration, both the convulsion thresholds of mice in A and D group were higher than that of mice in N group(P<0.05). However, at this point, the difference of the convulsion thresholds of mice between A and D group was not statistically significant(P>0.05). Conclusion Alcohol dependence has anticon?vulsant effect. Alcohol dependence weakens the anticonvulsant effect of diazepam.

Based on traditional Chinese medicine (TCM) herb data of inpatient department and senior famous TCM doctors from many TCM hospitals in China. Existing problems of TCM herb data standardization preprocessing were analyzed in order to explore scientific and reasonable preprocessing program which can provide technical support for the accurate analysis of herbal information. Clinical medicine doctors and herbal pharmacists collaborated and analyzed the real-world TCM herb data collected from multi-regions. In connection with characteristics of TCM, data mining was combined in the analysis of requirement to identify existing problems and explore appropriate problem-solving solutions. The results showed that based on the Pharmacopoeia of the People's Republic of China (PPRC, 2010 version) and regional herb preparing and dispensing guidelines, the herb collection rules, methods and processes were made for the herb data standardization. Herbal data processing program for different regions were formulated. It was concluded that herb data standardization rules and methods made by this plan solved standardization and accuracy of TCM herb data analysis and utilization in multi-area.

Objective:To explore the application and effect of flipped classroom in community clinical pharmacist training.Methods:Seventeen pharmacists trained in 2017-2018 were used as the control group and received traditional teaching mode. Fourteen pharmacists trained in 2019-2020 were used as the experimental group and received the flipped classroom teaching mode. Finally, the teaching effect was evaluated through the trainees' graduation examination results and satisfaction degree. The SPSS 25.0 was used to conduct the t test and chi-square test. Results:The task performance, prescription audit scores, clinical practice scores, and total scores in the experimental group were significantly higher than those in the control group ( P<0.05). However, there was no significant difference in usual performance between the two groups ( P>0.05). For satisfaction survey, the total score of Likert scale in the experimental group was (20.1±3.4), which was significantly higher than that in the control group (16.9±3.4). However, there was no significant difference in the satisfaction of clinical practice and teachers' level between the two groups ( P>0.05). Conclusion:Flipped classroom can improve the enthusiasm of community clinical pharmacist trainees to participate in learning, increase the level of the trainees' theoretical knowledge and professional practice, and is conducive to the cultivation of high-quality community clinical pharmacists.

Objective To investigate the cognition of colorectal cancer-related knowledge and influencing factors of patients with middle- and advanced-stage colorectal cancer in ethnic minority areas of Inner Mongolia. Methods According to the national population and the prevalence of colorectal cancer, 277 patients with colorectal cancer were selected by stratified and random sampling in Inner Mongolia. The patients were surveyed in Baotou, Chifeng, Bayannaoer, and other hospitals. The questionnaire included patients' basic information, cognition of colorectal cancer risk factors and screening knowledge, screening information, etc. Results Before suffering from the disease, the patients' knowledge of colorectal cancer (risk factors, early screening knowledge, treatment methods) was low. About 54.9% of patients were unaware of high risk factors for colorectal cancer, 75.8% of patients did not understand the knowledge of early screening of colorectal cancer, and 37.5% of patients did not underst and the treatment of colorectal cancer. The main influencing factors of colorectal cancer cognition were education level and occupation. Patients who work in institutions and enterprises and with higher education level had better cognition. Conclusion Patients with middle- and advanced-stage colorectal cancer in Inner Mongolia have poor knowledge and awareness of risk factors and screening of colorectal cancer before diagnosis. Education level and occupation are factors influencing colorectal cancer cognition, therefore, people with low knowledge rate of colorectal cancer and low education level as well as unemployed laid-off people should be given priority intervention.

Objective:To construct a multi-label learning MRI model for assisting diagnosis of sports injury in knee.Methods:A total of 1 391 knee MRI cases from 1 343 young adults with sports injury in Affiliated Jinling Hospital Nanjing University School of Medicine were retrospectively enrolled. The image cases were randomly divided into training set ( n=973), validation set ( n=139) and test set ( n=279) with ratio of 7∶1∶2. The knee injuries were divided into six categories: meniscus injury, tendon injury, ligament injury, osteochondral injury, synovial bursa disorder and soft tissue injury. Using PyTorch V1.1.0 algorithm package, the Yolo model of deep learning was used to construct the MRI knee joint sports injury detection model. The model was validated on the test set, and the sensitivity, specificity and mean average precision of lesion detection were evaluated. Results:Among the 279 patients in test set, the mean average precision of meniscus injury, tendon injury, ligament injury, osteochondral injury, synovial bursa disorder and soft tissue injury were 83.1%, 89.0%, 88.0%, 85.8%, 85.5% and 83.2%, respectively, and the overall mean average precision was 85.8%. The model was most effective in detecting tendon injury. The sensitivity and specificity of the model for tendon injury were 91.2% and 87.1% respectively.Conclusions:The multi-label MRI knee joint exercise-related injury detection model based on deep learning can effectively assist in detecting the exercise-related injury of knee joint in each tissue structure, and is expected to improve the efficiency of diagnosis and treatment in orthopedics.