To investigate the clinical characteristics,diagnosis and treatment of intrahepatic biliary cystadenoma,a total of 7 patients with intrahepatic biliary cystadenoma admitted in our department from January 2008 to June 2013 were enrolled and the clinical data (i.e.clinical manifestations,imaging features and surgical treatment) were analyzed retrospectively.All the 7 patients were female and diagnosed as intrahepatic biliary cystadenoma.Five cases complained right upper abdominal pain of various severities.Color Doppler ultrasound,CT and MRI confirmed the diagnosis in all patients.The surgery included irregular fight hepatectomy (n =2),left lateral lobe hepatectomy (n =3),and left hepatectomy (n =2).Patients with intrahepatic biliary cystadenoma usually manifest nonspecific clinical symptoms,and thus are prone to be misdiagnosed as simple hepatic cysts.For such patients,surgery is of first choice,and complete resection is the key to avoiding the recurrence and malignancy.

Physical restraint is a complex and dynamic process in which nurses are the main decision makers and implementer. This article is to review the factors influencing the implementation of physical restraint in ICU nurses, and summarize from 4 aspects: nurses' own factors, environmental factors, promotion measures of rational use of physical restraint and ethical factors, so as to provide a basis for the effective clinical intervention measures in the future.

China has entered an aging society,fall in the elderly often causes their physical and mental damage and even be life-threatening.Literature reviews studying on fall prevention in the elderly discovered that the improvement of the lower-extremity muscle strength can reduce the fall incidence in the elderly.This paper summarized the current researches on the methods for elderly people's lower-extremity muscle strength improvement.In addition,this paper also gave an analysis of both advantages and disadvantages of these methods,in order to provide a theoretical evidence and reference for the future study in improving the lower-extremity muscle strength.

Objective? To analyze hot research areas of nutrition support for cancer patients from 2008 to 2017, so as to provide guidance for the development of researchin nutrition support for the cancer patients in our country. Methods? Databases including CNKI, Wanfang, and VIP were searched with the subject or key words of "tumor""cancer""nutrition support/nutritional support", and databases including PubMed, Web of Science were searched with the subject or keywords of "cancer""tumor""malignant tumor"and"nutrition support/nutritional support" to review the relevant literature published from 2008 to 2017. Softwares including BICOMB 2.0 and SPSS 23.0 were used to generate high-frequency keywords, and construct cluster analysis. Results A total of 889 articles were retrieved and the number of articles showed an increasing trend on the whole. There were 69 core authors with≥3 published articles, and 62 high frequency subject words with word frequency ≥21 times. Cluster analysis showed that the research mainly focused on four fields: perioperative nursing of gastrointestinal cancer patients; nutritional risk screening and prognostic factors in gastrointestinal cancer patients; nutritional status and quality of life of patients treated with chemotherapy/radiotherapy;nutritional assessment and intervention for malignant oncology patients. Conclusions? The concept of tumor nutrition has been gradually developed, but there is still great room for development in the future in terms of the depth and breadth of research, early identification of patients with nutritional risk, nutritional assessment, formulation of feasible nutritional intervention programs and measures to improve the prognosis of patients and their quality of life.

Objective To investigate the clinical application value of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach.Methods A retrospective analysis was conducted on the clinical data of 67 patients with complex posterior lateral tibial plateau fractures treated with the suprafibular approach.Patients were divided into 3D printing group(35 cases)and conventional group(32 cases)based on whether 3D printing simulation surgery was used preoperatively.The operation time,intraoperative blood loss,and intrao-perative fluoroscopy frequency were compared between the two groups.Postoperative complications such as incision infection,popliteal vessel injury,and common peroneal nerve injury were observed.Fracture healing time was recorded during follow-up,and Rasmussen scores were evaluated at 6 months postoperatively.The Hospital for Special Surgery(HSS)knee function score was assessed during the final follow-up.Results The follow-up duration for 67 patients was 14 to 22 months.One patient in each group developed postoperative incision infection,and no complications such as poplite-al vessel injury,common peroneal nerve injury,or deep venous thrombosis of the lower extremity oc-curred.The operation time,intraoperative blood loss,and intraoperative fluoroscopy frequency were significantly lower in the 3D printing group than in the conventional group(P＜0.05).There were no significant differences in fracture healing time,Rasmussen scores at 6 months postoperatively,and HSS scores during the final follow-up between the two groups(P＞0.05).Conclusion The application of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach can optimize surgical plans,shorten operation time,and reduce intraoperative blood loss and fluoroscopy frequency.

Objective To investigate the clinical application value of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach.Methods A retrospective analysis was conducted on the clinical data of 67 patients with complex posterior lateral tibial plateau fractures treated with the suprafibular approach.Patients were divided into 3D printing group(35 cases)and conventional group(32 cases)based on whether 3D printing simulation surgery was used preoperatively.The operation time,intraoperative blood loss,and intrao-perative fluoroscopy frequency were compared between the two groups.Postoperative complications such as incision infection,popliteal vessel injury,and common peroneal nerve injury were observed.Fracture healing time was recorded during follow-up,and Rasmussen scores were evaluated at 6 months postoperatively.The Hospital for Special Surgery(HSS)knee function score was assessed during the final follow-up.Results The follow-up duration for 67 patients was 14 to 22 months.One patient in each group developed postoperative incision infection,and no complications such as poplite-al vessel injury,common peroneal nerve injury,or deep venous thrombosis of the lower extremity oc-curred.The operation time,intraoperative blood loss,and intraoperative fluoroscopy frequency were significantly lower in the 3D printing group than in the conventional group(P＜0.05).There were no significant differences in fracture healing time,Rasmussen scores at 6 months postoperatively,and HSS scores during the final follow-up between the two groups(P＞0.05).Conclusion The application of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach can optimize surgical plans,shorten operation time,and reduce intraoperative blood loss and fluoroscopy frequency.

Objective To investigate the main pharmacological basis and mechanism of action of Guhuaisi Kangfu Pill(GHSKF)in the treatment of steroid-induced osteonecrosis of the femoral head(SONFH).Methods The active constituents and targets of GHSKF were screened by using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and other databases.The speculative targets of SONFH were screened out based on GeneCards and Online Mendelian Inheritance in Man(OMIM)databases.The gene modules and hub genes of SONFH were identified using a weighted gene co-expression network analysis(WGCNA).The intersection of the two targets and the result of WGCNA was taken to obtain the potential targets of GHSKF for the treatment of SONFH.The key active constituents were screened with the"active constituent-target"network,which was constructed by the Cytoscape software.Then,the STRING database was used to construct the protein interaction network to screen the key targets.The Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis of key targets was performed,and the relationship between key active constituent,key targets and key signaling pathways was explored.Finally,the molecular docking between key active constituents and key targets was verified.In addition,the SONFH rat model was used for experimental verification.Results A total of 146 compounds and the corresponding 346 targets were identified based on the TCMSP database.A total of 4 187 targets of SONFH were obtained based on GeneCards and OMIM databases.In addition,twelve gene modules and 2 556 hub genes of SONFH were screened out based on WGCNA.Quercetin,luteolin and kaempferol were key active ingredients for the treatment of SONFH.Various signaling pathways such as PI3K/AKT were involved.Molecular docking showed the key active ingredients had good binding activity with the key targets.The results of animal experiments demonstrated that GHSKF could improve bone biological alterations by up-regulating AKT1,PI3K,RUNX2,and down-regulating the expression of Caspase-3 and IL-6(P＜0.01),which verified some results of the network pharmacology prediction.Conclusion We analyzed the potential mechanism of action of GHSKF for the treatment of SONFH using network pharmacology and animal experiments,which may provide a reference for further research on its pharmacological basis and targets.

ObjectiveThis paper aims to systematically collect and organize ancient and modern clauses and studies containing Xieqingwan， excavate and analyze the key information of Xieqingwan， and provide a reference for facilitating the development of the classic formula Xieqingwan. MethodsThe composition， dosage， decocting methods， usage， and other key information of Xieqingwan in ancient traditional Chinese medicine books were collected and analyzed by means of literature research and metrological methods. The modern clinical application of Xieqingwan was summarized. ResultsA total of 42 pieces of effective data involving 32 ancient traditional Chinese medicine books were collected. Xieqingwan was first recorded in Xiaoer Yaozheng Zhijue. The drug origin of this formula is basically clear in the ancient traditional Chinese medicine books. The modern drug usage and decocting method were as follows： Angelicae Sinensis Radix， Gentianae Radix et Rhizoma， Chuanxiong Rhizoma， Gardenia seeds， Radix et Rhizoma Rhei， Notopterygii Rhizoma et Radix， and Saposhnikoviae Radix were grounded to fine powder， decocted with honey， and finally formed into pills with the size of a chicken head （1.5 g）. It was suggested that half a pill or one pill were taken for one dose with warm Lophatheri decoction and sugar. The indications and clinical application had developed from the recordings in Xiaoer Yaozheng Zhijue and evolved from pediatrics to ophthalmic otolaryngology， neurology， dermatology， digestion， and respiratory diseases. The main pathogenesis of these diseases is heat in the liver meridian and is treated. The effect of Xieqingwan is "clearing away heat and toxicity， removing fire and relaxing the bowels， and dispersing swelling and relieving pain". It is recommended to use the corresponding preparation methods in the 2020 Edition of Pharmacopoeia of the People's Republic of China. Modern clinical studies are centered around the clinical application of Xieqingwan， which is often modified and used in treating Tourette syndrome， herpes， febrile convulsion， sleepwalking， and insomnia. ConclusionThis paper conducts a thorough textual research of the key information of Xieqingwan， induces its historic evolution， and confirms its key information， so as to provide a reference for the future development of Xieqingwan.