Objective To evaluate the effects of epidural capsaicin on pain threshold and nerve tissue structure in adult rats. Methods Twenty-four adult male Wistar rats weighing 250-300 g were used in this study. A catheter was inserted into epidural space at L5,6 according to the method of Philippe. 0.4 ml of capsaicin 0.1% (group A), 0.25% (group B) or 0.5% (group C) or 10% Tween 80 (control group) was injected via the epidural catheter. Pain threshold was measured by thermal stimulation of the tail before (baseline) and on the 3rd, 7th and 14th day after epidural capsaicin. The animals were then killed. The lumbar segment (L4-6) of the spinal cord and spinal nerve roots were removed immediately for light and electron microscopic examination. Results Pain threshold was significantly higher in group A, B and C than in control group (P

Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia.

Objective To observe the clinical effects of Huoxue Dingxuan Capsules on treatment of vertebral artery type of cervical spondylosis, and evaluate its efficacy and safety. Methods Totally 130 cases of vertebral artery type of cervical spondylosis were randomly assigned to treatment group and control group, and treated with Huoxue Dingxuan Capsules and Sibelium capsules respectively. Integration method was used to compare the differences of main symptoms and signs, the overall efficacy and safety were evaluated, and relapse after six months was followed up. Results Both groups had a significant effect on the improvement of signs and symptoms in vertebral artery type of cervical spondylosis, the total efficiency was 94.03%(63/67) in treatment group and 82.54% (52/63) in control group. The treatment group had a better effect on the overall efficacy and relieving symptoms and signs compared with the control group (P<0.01). The mean blood flow velocity had a significant change after treatment (P<0.05), and the treatment group was better than the control group (P<0.01). Within six months, the treatment group had 4 cases (6.34%) with mild recurrence of symptoms and signs, and the control group had 18 cases (34.61%), the difference between the two groups was statistically significant (P<0.05), and no severe recurrence was found. The two groups showed no side effects. Conclusion Huoxue Dingxuan Capsules is safe and effective for treating vertebral artery type of cervical spondylosis, and the long-term efficacy and subjects’ compliance are better than oral Sibelium capsules.

Objective To evaluate the effect of continuous passive motion (CPM) as an adjunct to active physiotherapy on pain and range of motion (ROM) after knee arthroplasty. Methods 20 female osteoarthritis patients (40 knees) undergoing bilateral knee arthroplasty were assigned into two groups. The experimental group received CPM and active physiotherapy twice a day while the control group received active physiotherapy only. They were assessed with visual analogue scale (VAS) and goniometer on pain and ROM of knee before and after operation. Results There were no statistical difference between these two groups for any outcome measures either 2 weeks or 3 months after operation (P>0.05), and they all improved in pain and ROM 3 months after operation compared with before (P<0.01). Conclusion CPM as an adjunctive therapy is not found to have an additional effect on pain or ROM 3 months after operation while active physiotherapy was used.

The pharmacodynamic (PD) and pharmacokinetic (PK) properties of Huangqin Tang (HQT) were investigated in yeast-induced febrile rats. Blood sample and rectal temperature data of the rats were collected at different times after single oral administration of HQT at 20 g x kg(-1). The plasma concentrations of paeoniflorin, baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid were quantified by a sensitive liquid chromatography-tandem mass spectrometric (LC-MS) method. The blood concentrations of PGE2, 1L-1β and TNF-α were detected by radioimmunoassay (RIA). All pharmacokinetic parameters were processed by non-compartmental analysis using WinNonlin software. The potential relationship between the mean concentration of eight constituents and the antifebrile efficacy was investigated by calculating Pearson correlation coefficients. It was found that HQT had significant antifebrile efficacy in yeast-induced febrile rats, but had no effect to normal rats. The antifebrile effect of HQT can be attributed to the inhibition of PGE2, 1L-1β and TNF-α. The constituents (baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid) in febrile rats had delayed absorption and elimination, a longer residence time in the body, and higher C(max) and AUC than those in normal rats. Febrile condition could affect the pharmacokinetic behaviour of HQT in vivo; the flavonoids with the same backbone showed the similar fate in the body; baicalein and wogonin had a strong positive correlation (R > 0.66, P ≤ 0.02) with the antifebrile efficacy determined. Together, these constituents demonstrated different pharmacokinetic properties in the febrile body.

The current study aims to investigate the pharmacokinetic properties of Huangqin Tang on different oral doses. An LC-MS method for simultaneous determination of flavonoids and terpenoids in rat plasma was developed and validated. Plasma samples were treated with hydrochloric acid (containing 1% ascorbic acid), precipitated with acetonitrile, separated on a Zorbax SB-C18 column, detected by single quadruple mass spectrometry with an electrospray ionization interface, and quantified using selected ion monitoring mode. All pharmacokinetic parameters were processed by non-compartmental analysis using WinNonlin software. The results of specificity, linearity, intra-day and inter-day precisions, accuracy, and stability for LC-MS assay were suitable for the quantification of paeoniflorin, baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid in rat plasma. The concentration-time profiles of baicalin, wogonoside, baicalein, wogonin, oroxylin A and glycyrrhizic acid showed double-peak phenomenon after Huangqin Tang was orally administered at 40 g x kg(-1) dose; all eight constituents in rat plasma showed good dose-exposure relationship within the dosage of 10-40 g x kg(-1); although plasma concentrations were different, the flavonoids with the same backbone showed the similar fate in the body with the corresponding dosage. In conclusion, the LC-MS assay was successfully applied for the pharmacokinetic study of multi-constituents of Huangqin Tang with different doses. Additionally, these constituents demonstrated good pharmacokinetic properties in the body.

Objective:To study the correlation between serum bilirubin and cystatin C in patients with type 2 diabetes mellitus.Methods:A retrospective cohort study was conducted on 750 patients who were in the Affiliated Hospital of Jining Medical University from June 2017 to May 2018. The clinical data were collected, and the correlation between serum total bilirubin, direct bilirubin, indirect bilirubin and cystatin C was analyzed.Results:According to the results of single factor analysis, after adjusting the related confounding factors, the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin, indirect bilirubin and cystatin C. When the total bilirubin was <15.9 μmol/L, for every increase of 1 μmol/L in total bilirubin, cystatin C decreased 0.008 mg/L ( β = - 0.008, 95% CI - 0.014 to - 0.002, P<0.01); when indirect bilirubin was <11.5 μmol/L, for every increase of 1 μmol/L in indirect bilirubin, cystatin C decreased 0.011 mg/L ( β = - 0.011, 95% CI - 0.018 to - 0.003, P<0.01). When cystatin C was grouped according to the normal range (cystatin C<1.25 mg/L), after adjusting the related confounding factors, the smooth curve fitting showed that there was a U-shaped relationship between the total bilirubin and indirect bilirubin with cystatin C; when total bilirubin was <15.5 mol/L, for every increase of 1 μmol/L in total bilirubin, the risk of cystatin C exceeding the normal value was reduced by 17% ( OR = 0.83, 95% CI 0.71 to 0.96, P<0.01); when total bilirubin was ≥15.5 μmol/L, for every increase of 1 μmol/L in total bilirubin, the risk of cystatin C exceeding the normal value was increased by 12% ( OR = 1.12, 95% CI 1.01 to 1.25, P<0.05); when indirect bilirubin was <11.8 μmol/L, every increase of 1 μmol/L in indirect bilirubin, the risk of cystatin C exceeding the normal value was reduced by 20% ( OR = 0.80, 95% CI 0.67 to 0.95, P<0.01). However there was no significant correlation between direct bilirubin and cystatin C. Conclusions:There is a U-shaped relationship between total bilirubin, indirect bilirubin and cystatin C. At physiological concentrations, the increase of total bilirubin and indirect bilirubin can reduce cystatin C.

At present, the situation of COVID-19 epidemic prevention and control in China is gradually improving, but the situation of overseas import prevention and control remains difficult. The COVID-19 epidemic may exist for long due to the undetermined source of infection, the difficulty in completely cutting off the transmission route, and a large number of susceptible people. Therefore, prevention and control will be a long-term and arduous task, making it necessary to adhere to the principle of combining emergency response with regular prevention and control, coordinating the epidemic prevention and social-economic development in a balanced way. In retrospect, the epidemic has exposed the ambiguous positioning and unsatisfying hardware construction of hospital laboratory departments, and delayed intervention of laboratory experts in the public health treatment system of China. This paper reflects on the hospital laboratory departments′ problems during the anti-epidemic activities, and put forward suggestions to improve the future development of clinical laboratories in the national public health system.

Objective To explore the influence of the dual tutorial teaching mode on the undergraduate
nursing students′ critical thinking in the clinical training. Methods Two hundred and sixteen full-time undergraduate nursing students who did internships in the second Affiliated Hospital of Wenzhou Medical University from September 1st, 2013 to September 1st, 2015 were divided into the experimental group ( n=111) and the control group ( n=105) using the random number table. The nursing students in the control group received the traditional post tutor teaching mode, while the nursing students in the experimental group received the dual tutorial system teaching mode in the clinical teaching. After the internship, nursing students in the two groups completed the general information questionnaire and the critical thinking disposition inventory.Results The scores of critical thinking ability, open-minded ability, analytical ability, systematic ability, critical thinking self-confidence, curiosity, cognitive maturity dimension of the nursing students in the experimental group were (280.32±29.83), (40.53±5.75), (43.08±5.32), (37.69±6.08), (40.16±5.60), (43.89±6.71), (38.53± 7.17) respectively, which were significantly higher than the scores gained by the nursing students in the control group (t=-7.587, -6.138, -8.555, -3.530, -6.727, -8.023, -3.097;P<0.05).In the control group, they were (210.63±25.25), (29.86±6.31), (26.61±5.71), (32.19±6.17), (28.76±5.82), (25.96±6.53), (32.99±7.41), respectively.Conclusions The dual tutorial teaching mode improves undergraduate nursing trainees′critical thinking ability including open-minded ability, analytical ability, systematic ability, critical thinking self-confidence, curiosity, cognitive maturity, which can be applied in the clinical teaching of nursing students.

Objective To explore the current status and influencing factors of subjective well-being (SWB) in student nurses so as to provide a basis for formulating corresponding countermeasures.Methods A total of 652 student nurses at a classⅢ grade A hospital in Wenzhou City were selected as subjects by chester sampling from January 2015 to January 2017. They were investigated with the general condition questionnaire and the Chinese version of the Warwick-Edinburgh mental well-being scale (WEMWBS) . Results The total score of WEMWBS was (51.29±9.34) with a middle level in student nurses. Belief, self-report character, sexes, annual household income, body mass index had influences on SWB of student nurses (P<0.01).Conclusions The level of SWB of student nurses needs to be improved. Nurse educators and managers should pay high attention to mental health of student nurses and take positive measures to improve the SWB of student nurses so as to stabilize the construction of nursing team.