OBJECTIVE:To establish a method to distinguish between synthetic caffeine and natural caffeine METHODS:To identify the related substances obtained from synthetic caffeine and natural caffeine by HPLC,TLC,fluorescence spectrophotometry and X-ray powder diffraction RESULTS:Synthetic caffeine and natural caffeine can be identified by testing the related substances in them CONCLUSION:Using the described method,synthetic caffeine and natural caffeine can be discriminated accurately

Significant therapeutic effect was shown in treating 68 cases of acute lumbar sprain by puncturing Suliao(GV 25) combined with the patient's movement, and its total effective rate was 91.1%.

Objective To observe the effect of JIN’s three needle therapy plus mirror therapy for knee joint movement on lower-limb function of patients with hemiplegia after cerebral infarction.Method Seventy-four patients with hemiplegia after cerebral infarction were randomized into a treatment group and a control group, 37 cases in each group. The treatment group was intervened by JIN’s three needle therapy plus mirror therapy for knee joint movement, while the control group was by mirror therapy for knee joint movement alone. After 4-week treatment, the Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were adopted for evaluating motor function of the affected limb and the activities of daily living (ADL), the Functional Ambulation Category scale (FAC) for assessing the walking ability, and the Twichell-Brunnstrom Stages of Stroke Recovery for determining the stage of post-stroke hemiplegia. Result After the intervention, the FMA and MBI scores were significantly changed in both groups (P<0.05). The changes of FMA and MBI scores in the treatment group after the treatment were significantly different from those in the control group (P<0.05). After the treatment, there were significant between-group differences in comparing the FAC and Brunnstrom grading results (P<0.05).Conclusion JIN’s three needle therapy plus mirror therapy for knee joint movement is an effective approach in treating hemiplegia after cerebral infarction, and it can improve the lower-limb motor function and the ADL.

Objective To summarize the perioperative nursing of huge malignant lobulated breast tumor, so as to promote the recovery of patients. Methods A total of 11 patients with huge malignant lobulated breast tumor patients were selected, assessed the preoperative status,finished breast tumor site nursing, strengthen psychological nutritional assessment, the adjustment of the respiratory system for the operation, prevent falls. In addition to do a good job in general nursing and postoperative pain management, but should also focus on the observation of the chest wall flap, drainage tube care, to prevent bleeding and infection, etc. Results By implementing the nursing plan, 1 case of breathing difficulties preoperative patients with respiratory function improved, 1 case of refuse treatment of patients accepted surgical treatment after psychological intervention, 2 cases of postoperative patients with skin flap necrosis, local treatment, after compression bandage, 1 case of good recovery, 1 case of poor treatment effect for the wound recovered well after back surgery graft;1 case of patients with subcutaneous effusion, to adjust the drainage tube, suction fluid, after compression bandage, partial treatment, recovering well. Patients were good recovery, discharged smoothly. Conclusions By constantly sum up experience, through positive assessment of patients after preoperative mental and physical health and attaches importance to patients' skin flap, bleeding, pain, completes the drainage tube nursing and prevention of infection, can effectively promote the recovery of patients.

Objective To explore the effect of manual lymphatic drainage on prevention of postoperative axillary web syndrome of breast cancer. Methods From June to December, 2015, 400 breast cancer patients after modified radical mastectomy were randomly divided into control group (n=200) and intervention group (n=200). The control group accepted routine functional exercise on affected upper limbs, while the intervention group accepted manual lymphatic drainage in addition. The incidence of axillary web syndrome in both groups was compared one, two and three months after operation. Results The incidence of axillary web syndrome was less in the intervention group than in the control group in all the time points after operation (χ2>6.17, P<0.05). Conclusion Manual lymphatic drainage can effectively pre-vent axillary web syndrome in patients with breast cancer after modified radical mastectomy.

Background/Aims: Disrupted bile acid regulation and accumulation in the liver can contribute to progressive liver damage and fibrosis. However, the effects of bile acids on the activation of hepatic stellate cells (HSCs) remain unclear. This study investigated the effects of bile acids on HSC activation during liver fibrosis, and examined the underlying mechanisms. Methods: The immortalized HSCs, LX-2 and JS-1cells were used for the in vitro study. in vitro, the adeno-associated viruses adeno-associated virus-sh-S1PR2 and JTE-013 were used to pharmacologically inhibit the activity of S1PR2 in a murine model of fibrosis induced by a 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) diet. Histological and biochemical analyses were performed to study the involvement of S1PR2 in the regulation of fibrogenic factors as well as the activation properties of HSCs. Results: S1PR2 was the predominant S1PR expressed in HSCs and was upregulated during taurocholic acid (TCA) stimulation and in cholestatic liver fibrosis mice. TCA-induced HSC proliferation, migration and contraction and extracellular matrix protein secretion were inhibited by JTE-013 and a specific shRNA targeting S1PR2 in LX-2 and JS-1 cells. Meanwhile, treatment with JTE-013 or S1PR2 deficiency significantly attenuated liver histopathological injury, collagen accumulation, and the expression of fibrogenesis-associated genes in mice fed a DDC diet. Furthermore, TCAmediated activation of HSCs through S1PR2 was closely related to the yes-associated protein (YAP) signaling pathway via p38 mitogen-activated protein kinase (p38 MAPK). Conclusions TCA-induced activation of the S1PR2/p38 MAPK/YAP signaling pathways plays a vital role in regulating HSC activation, which might be therapeutically relevant for targeting cholestatic liver fibrosis.

Objective To investigate the effect of small annular electrode assisted electrosurgical excision of cervical canal mucosa on cervical loop electrosurgical excision procedure ( LEEP ) in patients with cervical erosion and endocervicitis. Methods From March 2016 to March 2017,one hundred and twenty cases with cervical erosion treated in the Third People′s Hospital of Shenzhen were selected and were randomly divided into the control group and the observation group,with 60 cases in each group. The patients in the control group were treated with conical or LEEP while patients in the observation group were treated by putting the small ring electrode into the cervical canal under 0. 4 ～ 0. 6 cm longitudinal resection to treat cervical inflammatory lesions based on the treatment of the control group. The postoperative and postoperative recovery,postoperative efficacy and complications of the two groups were compared. Results There was no statistical significance between the observation group and the control group in the time of operation,the amount of bleeding during operation,and the time of vaginal drainage after operation ( P>0. 05 ) . The curative rate of the observation group and the control group were 75. 0％(45/60) and 51. 7％(31/60) at 1 month after operation respectively,and they were 95. 0％( 57/60) and 70. 0％ ( 42/60) at 2 months after operation. The difference was statistically significant ( P<0. 05) . The incidence of eversion of cervical columnar epithelium in the observation group and the control group were 5. 0％ ( 3/60) and 18. 3％ ( 11/60) at 1 month after the operation,and the difference was statistically significant (χ2=12. 4,P<0. 05) . The incidence of eversion of cervical columnar epithelium in the observation group and the control group were 3. 3％ ( 2/60) and 13. 3％ ( 8/60) at 2 months after the operation,and the difference was statistically significant (χ2=9. 51,P<0. 05) . No cervical laxity and stenosis occurred in both groups at 6 months after the operation. Conclusion The LEEP modified by small annular electrode can effectively improve the curative rate of cervical erosion in patients with endocervicitis, reduce the incidence of cervical columnar eversion,and does not prolong the operation time and does not increase the risk of bleeding or affect postoperative uterine function,which has good clinical value.

Objective To explore heterogeneous subtypes of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation and the characteristics differences of different types of children after liver transplantation. Methods Seven hundred and forty-one children who underwent living-related liver transplantation were enrolled. The self-designed general information questionnaire, Chinese version of 5-Item World Health Organization Well-Being Index (WHO-5) and the parent-report version of the Strengths and Difficulties Questionnaire (SDQ) were filled out by their guardians. The scores of five dimensions of SDQ were used as the manifest variables of the model. The classification model of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation was constructed by latent profile analysis. The latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation were analyzed. The influencing factors of latent categories were analyzed by univariate analysis and logistic regression model. Results There were three latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation, including peer communication problem group (n=302), psychological and behavioral adaptation group (n=145) and psychological and behavioral adjustment difficulty group (n=294). The first two groups were merged into the psychological and behavioral health group (n=447), which had significant differences in the five dimensions and the total score of difficulties of SDQ compared with the psychological and behavioral adjustment difficulty group (n=294) (all P<0.001). Logistic regression analysis showed that age≤5 years old, primary disease of non-cholestatic liver disease, stem family were the risk factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation. Female gender, high education levels of parents and high WHO-5 score of guardians were the protective factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation (all P<0.05). Conclusions The psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation are heterogeneous. Medical staff should pay extensive attention to different characteristics of pediatric recipients after liver transplantation with different psychological and behavioral adaptation categories and adopt targeted screening and intervention strategies, aiming to improve psychological and behavioral adaptation outcomes of pediatric recipients after liver transplantation.

Objective Through the investigation of the status quo of the nursing staff in the general hospitals in Harbin, the present situation of the nursing managers in Harbin is evaluated, which provides the basis for the medical staff management, continuing education and training direction of Harbin medical institutions. Methods The social basic demographic situation, training, work content, work pressure and strength of 150 nursing managers in the Harbin general hospital were investigated by self-designed questionnaire. Survey data using EpiData3.1 and Excel 2010 software to establish a database, input, mapping, analysis. Results The nursing management personnel basic quality was good. Generally included department based on the actual work of the complete personnel division of labor and scheduling, responsible for items, equipment, drugs, ward management, responsible for other work assigned by department, hospital care tasks. 85％(127/150) of the staff undertook the nursing management of the department and undertook clinical nursing work;62％(93/150) of nursing managers believed that work was at full load. Most care managers thought the work pressure was higher. The stress source was mainly from the tension, responsibility and workload of the patient. The training of nursing managers focused on nursing skills and professional knowledge. The training form was mainly for expert lectures, intensive teaching and practical training. There was an urgent need to strengthen training on risk management, stress management, psychology, and management knowledge. Conclusions The basic quality of nursing management personnel in Harbin comprehensive hospital is good, but there is still a gap between the requirements of the international nurses' core competence, hospital managers should attach importance to constructing systematic training system for nursing management personnel, and strengthen the construction and cultivation of core competence of nursing management.

Objective To analyze the application value of evidence-based nursing(EBN) in LASEK surgery.Methods Totals of 120 cases of LASIK surgery patients from December 2013 to December 2015 were selected, and divided into observation group and control group by sortition. Patients in observation group received EBN, while patients in control group received routine nursing. Systolic blood pressure(SBP), diastolic blood pressure( DBP ) , heart rate, and SAS score before surgery, postoperative complications after 1 week, visual acuity, diopter and intraocular pressure after 4 weeks, and Haze grading are observed in two groups. Results The preoperative SBP, DBP and heart rate in observation group were lower than in the control group, SAS score in observation group was lower than the control group, differences were statistically significant ( P<0.05);complication rate 1. 67% in observation group was lower than 8. 67% in control group 1 week after surgery. The difference was statistically significant (χ2=5. 886, P<0. 05 ); 4 weeks after surgery, visual acuity in observation group was higher than that in control group, diopter was lower than in control group, and intraocular pressure was lower than in control group, The difference was statistically significant ( P<0.05);4 weeks after surgery, 1.67% patients in observation group were Haze 1 and was lower than that 11.67% in control group (P<0.05).Conclusions The application of EBN in LASEK surgery can effectively relieve patients′negative emotions, reduce the complication rate, and improve the surgical curative effect.