AIM: To establish a method for determination of astragloside Ⅳ in Danqi Injection (Radix Salviae Miltiorrhizae,Radix Astragali). METHODS:HPLC-ELSD with Hypersil C_(18) column was used.The mobile phase was composed of acetonitrile-water(38∶62).The flow rate was 0.85 mL?min~(-1).An evaporative light-scattering detector(ELSD) model 2000 was used as detector. RESULTS:For astragloside Ⅳ,the linear range was 1.074-(3.408 ?g),and the average recovery was 100.71%,RSD was 1.79%. CONCLUSION:The method is simple,accurate,reproducible and can be applied to the quality control of the preparation. anqi

Objective To retrospectively analyze the characteristics of postoperative complications of endoscopic submucosal dissection (ESD) in patients of different age groups with lesions at different locations . Methods From January 2011 to October 2017, at The First Affiliated Hospital of Zhejiang University , clinical data of 1688 patients who received ESD treatment (1799 ESD operations) were collected.The lesions were located in the esophagus (n =232), stomach (n =1225), duodenum (n =9), colon (n =152) and rectum (n =181).There were 500 patients (508 ESD operations) with underlying diseases, and 1188 patients without underlying diseases.Most patients with lesions at stomach, esophagus and colon rectum, and these patients were divided into four age groups <45 years (n =202), 4559 years (n =643), 6074 years (n =744), and ≥75 years (n =99).The postoperative complications rates of ESD in different lesions among four age groups were compared.Chi-square test was performed for statistical analysis .Results From 2011 to 2017, the complication rates after ESD were 20.0％ (8/40), 18.3％ (21/115), 15.9％ (35/220), 10.7％ (31/291), 11.3％ (40/355), 10.7％ (41 /384) and 10.7％ (42/394), respectively, and the difference was not statistically significant (χ2 =10.432, P =0.064).Further analysis revealed that the complication rates after ESD between 2011 and 2013 was significantly higher than that between 2014 and 2017 (17.1％, 64/375 vs.10.8％, 154 /1424);and the difference was statistically significant (χ2 =10.895, P <0.01).The complication rates of patients with lesions in the esophagus of <45 years group,4559 years group, 6074 years group and ≥75 years group were 4.5％ (1/22), 23.6％ (17 /72), 24.4％ (31 /127) and five cases (totally 11 cases).The complication rates of patients with lesions in the stomach of <45 years group,4559 years group, 6074 years group and ≥75 years group were 19.2％ (28 /146), 14.2％ (68 /479), 15.8％ (85 /539) and 16.4％ (10/61).The complication rates of lesions in the colon of <45 years group, 4559 years group, 6074 years group and ≥75 years group were one case ( totally 12 cases), 3.4％ (2 /58), 10.9％ (7/64) and five cases ( totally 18 cases), respectively.The complication rates of lesions in the rectum of <45 years group, 4559 years group, 6074 years group and ≥75 years group were 3.3％ (1 /30), 10.4％ (7 /67), 19.4％ (14/72) and two cases (totally 12 cases), respectively.There were significant differences in complication rates between different age groups with lesions in the esophagus (χ2 =10.894, P =0.012) and the colon (χ2 =13.540, P =0.004). In addition, the complication rates of patients with underlying diseases and without underlying diseases were 14.6％ (74 /508) and 12.5％ (149 /1188), respectively, and there was no statistically significant difference (χ2 =1.278, P =0.258).Conclusions The postoperative complications of ESD is closely associated with lesion location and age.For elderly patients, especially those with lesions in the esophagus and colon , paying more attention and strengthening the clinical practice can effectively reduce the incidence of complications .

Objective To investigate the clinical presentation,diagnosis,and surgical management of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis.Methods One case of anti-NMDA receptor encephalitis in a previously healthy 17-year-old female related to the development of NMDA receptor autoantibodies triggered by an ovarian teratoma was reported.The related literature was reviewed and the clinical feature was summarized.Results Removal of the ovarian teratoma combined with intravenous immuneglobulin and corticosteroid proved curative with eventual resolution of the paraneoplastic disease process and associated psychiatric symptoms.Conclusion Increasingly,reports of anti-NMDA receptor encephalitis associated with ovarian teratomas,as well as a novel assay to measure these antibodies suggest an etiology for this disease process that may be amenable to prompt surgical excision.

OBJECTIVETo investigate the effectiveness of using continuous veno venous hemofiltration (CVVH) in the treatment of acute necrotizing pancreatitis (ANP).

METHODSThirteen ANP patients were involved in this study, including 4 females and 9 males, averaging 50.6 +/- 10.8 years old. CT scans upon admission revealed 33% necrosis involving the body of the pancreas in 2 patients, 67% necrosis in 3 patients and 100% necrosis in the other 8; the CT severity score was 8.9 +/- 2.1. CVVH was maintained for at least 72 hours and the AN69 hemofilter (1.2 m(2)) was changed every 24 hours. The ultrafiltration rate during CVVH was 2993.9 +/- 983.0 ml/h, the blood flow rate was 250 - 300 ml/min, and the substitute fluid was infused in a pre-diluted manner. Low molecular weight heparin was used as anticoagulant.

RESULTSCVVH was well tolerated in all the patients. Bloody abdominal cavity drainage fluid was observed in 2 patients, but no other side-effects related with CVVH were observed. Two patients died of systemic fungal infections and another died of intracranial fungi infection, resulting in an ICU mortality of 23.1%. Ten of the patients survived in the ICU, but one of them died for other reasons unrelated to the SAP before discharge. The APACHE II score before CVVH was 15.2 +/- 6.5, but decreased significantly to 8.1 +/- 5.3, 7.5 +/- 4.9 and 8.0 +/- 5.2 at the 24th, 48th and 72nd hour after CVVH, respectively (P < 0.01). Serum concentration of IL-1beta and TNFalpha decreased to the trough at the 6th hour after a new hemofilter was used and increased slowly to pre-CVVH levels 12 hours later. After CVVH had ceased, the serum levels of two cytokines increased to their peaks at the 120th hour and decreased eventually at the 144th hour. The sieving coefficient (SC) of IL-1beta and TNFalpha was 0.33 +/- 0.11 and 0.16 +/- 0.08.

CONCLUSIONCVVH offered therapeutic options for ANP and was well tolerated resulting in clearance of IL-1beta and TNFalpha; CVVH at early stages of SAP may contribute to the improvement of outcome.

Adult ; Aged ; Female ; Hemofiltration ; adverse effects ; Humans ; Interleukin-1 ; analysis ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; therapy ; Tumor Necrosis Factor-alpha ; analysis

Objective To quantitatively analyze and evaluate the content of rehabilitation policy for people with disabilities in China. Methods This study focused on ten national policies of disability rehabilitation issued from 2021 to 2023.It employed text mining techniques to process policy texts and constructed a policy modeling consistency index model for dis-ability rehabilitation policies in China.The relevant policies were evaluated and analyzed quantitatively. Results The disability rehabilitation policies in China were relatively comprehensive in terms of policy transparency,op-erational mechanisms and policy nature.However,there was still a need for optimization in terms of policy per-spectives,target groups,incentive mechanisms,and other aspects. Conclusion The overall quality of disability rehabilitation policy texts at the national level in China is relatively good.There is a need to further enhance the predictability of policy objectives,clarify the responsibilities and division of labor among various departments,and improve policy incentive mechanisms in future policy formulation,which will further refine China's disability rehabilitation policy system and contribute to high-quality develop-ment of the disability cause.

Objective To assess the elderly health-related rehabilitation services(HRRS)needs from a community and population perspective and construct a community-based elderly HRRS framework. Methods The limitation of the elderly HRRS was analyzed,a community-based elderly rehabilitation service framework based on the International Classification of Functioning,Disability,and Health(ICF)was guided,and the imple-mentation path was proposed. Results This paper analyzed the evaluation,provision and models of existing community rehabilitation services both do-mestically and internationally.It combined the background and practical requirements of China's new era to eluci-date the connotation of HRRS for the elderly in the community.It proposed constructing a community-based el-derly HRRS framework guided by ICF.The paper also offered implementation strategies for promoting communi-ty-based elderly HRRS,focusing on enhancing leadership and policy,financing,human resources,service provi-sion,technology,and digital intelligence empowerment.It provided reference and insights for advancing the na-tional strategy of population aging and implementing the Healthy China strategy. Conclusion It is suggested to continue to accelerate the development of rehabilitation capacity,and increase the supply of HRRS,to meet the diverse needs of the masses of HRRS.

ObjectiveTo investigate the distribution and trend of rehabilitation personnel of China Disabled Persons' Federation (CDPF) system and the people with disabilities (PWDs) using geographical gravity model. MethodsBased on ArcGIS and statistical data, the distribution of geographical center of gravity of the rehabilitation personnel of the CDPF system from 2011 to 2021 was analyzed. According to the economic development, the areas were divided into three regions, and the eastern region included eleven provincial units, the central region includes eight provincial units, and the western region included twelve provincial units. ResultsCompared with 2011, rehabilitation staffs per thousand PWDs increased at 107.5% in 2021, 81.1%, 114.2% and 174.1% for the eastern, central, and western regions, respectively; professional staffs increased at 190.5%, 148.8%, 284.6% and 280.6% for the eastern, central, and western regions, respectively; managerial staff increased at 80.0%, 46.8%, 554.3% and 128.1% for the eastern, central, and western regions, respectively. Compared with 2011, the geographical center of gravity of the rehabilitation personnel moved about 330.9 km in 2021, while the geographical center of gravity of the PWDs moved about 169.64 km. ConclusionThe rehabilitation personnel in the CDPF system is the most in the eastern region and least in the western region. The tracks of the geographical center of gravity of the three kind of rehabilitation personnel in the CDPF system are relatively consistent. The rehabilitation personnel in the eastern region are more concentrated than those in the western region, and the density of the PWDs is more westward than that of the rehabilitation personnel, and coordination is not a perfect match yet. It is necessary to strengthen the rehabilitation personnel allocation in the western region, to balance distribution of human resources for rehabilitation of PWDs among regions.

Objective To explore the application and method of World Health Organization Rehabilitation Competency Framework (RCF) in rehabilitation human resource management, and provide theoretical and practical reference for rehabilitation human resource management.Methods Based on the International Standard Classification of Occupations issued by the International Labour Organization, the application scope of RCF was systematically analyzed. The theoretical framework of rehabilitation human resource management based on RCF was constructed in combination with competency-based human resource management framework. On this basis, taking rehabilitation nurses as an example, the corresponding management methods and paths are proposed from four aspects of human resource management, including career management, recruitment and selection, training and development, and performance appraisal and salary management.Results Based on RCF, the theoretical framework of human resource management for rehabilitation nursing positions was constructed, and the main contents and processes of human resource management based on RCF were clarified from four aspects: recruitment and selection, training and development, performance appraisal and salary management, and career management. Occupational competency of rehabilitation professionals in International Standard Classification of Occupations was analyzed by RCF.Conclusion The rehabilitation competency framework constructed by WHO can be used to supplement the responsibilities of rehabilitation-related professionals in the International Standard Classification of Occupations issued by the International Labour Organization. RCF serves as a tool for practice managers and rehabilitation professionals in identifying selection criteria, learning objectives, and professional title assessment criteria. It can also be used in recruitment and selection, training and development, performance appraisal, salary management and career management in the field of rehabilitation human resource management.