OBJECTIVE:To provide new ideas for the supervision of TCM decoction for patients. METHODS:The mode of outsourced TCM decoction for patients in Nanjing and Hangzhou area were investigated and analyzed,especially their operation mode. The safety problems of quality of the mode were analyzed from the legitimacy and standardization. RESULTS & CONCLU-SIONS:The present problems include the mismatch of professional and technical personnel of TCM decoction pieces and their qua-lification requirements;the lack of communication of pharmacists and prescribers;no restrictions for outsourced decoction of toxic TCM decoction pieces for patients;the insufficient attention for the quality and safety of packaging materials;being difficult to im-plement the main responsibility of medical institutions,etc. It is suggested to establish the filing system of centralized TCM decoc-tion institution for patients;the stationed system of pharmacy technician in medical institutions;the training and evaluation system of dispensing,decocting and other stations;the regular inspection system of health and pharmaceutical administration department;the quality evaluation system of TCM decoction for patients by following up medical staff and patients. So that it can explore a new idea for monitoring ofclearing the powers of regulatory,full participation in medical institutions,standardization and management of pharmaceutical wholesale enterprises,active supervision by patients.

Objective:To study the effects of several herbal medicines on SMMC-7721 liver cancer cells with Fourier transform infrared spectrometer(FTIR). Methods: FTIR was employed to determine the infrared spectra(IRs) of SMMC-7721 liver cancer cells cultivated for 20 h with the extracts of Spica prunellae, Herba houttuyniae, Radix bupleuri and Herba artemisiae scopariae. Cluster analysis of IRs was also performed. Results: IR spectral parameters such as band shape, intensity and frequency of the blank, control and herbal-extract-treated cells were compared. There existed obvious blue shift of ? s(PO 2 -), ? as (PO 2 -) bands, red shift of ? as (CH 3), ?(CH 2) bands on the herbal-extract-treated cells IRs. The decreasing ratio of ? as (CH 3) to ? s(CH 2) peak intensity and the increasing ratio of ? s(PO 2 -) to ?(N-H) peak area indicated the destructive effect of herbal extracts on the membrane structure of SMMU-7721 cells and inhibitory effect on the DNA replication respectively. Cluster analysis successfully discriminated the herbal-extract-treated cells from the blank cells and the liver-oriented medicines from the non-liver-oriented medicine. Conclusion: FTIR provides another fast and effective approach to analyze the changes of cells treated with Chinese herbal medicines, which may help to illuminate the functional mechanism of Chinese herbal medicines.

Abstract Socioeconomic status is an important factor affecting all-cause mortality. Income, education and occupation alone or in combination have been employed as a measure of socioeconomic status; however, the study results vary in measures. Material mechanism, lifestyle mechanism, psychological mechanism and community neighborhood mechanism have been accepted as the main intermediate mechanisms for the impact of socioeconomic status on all-cause mortality; however, the contribution of these mechanisms remains controversial. Based on the international and national publications pertaining to the association between socioeconomic status and all-cause mortality from 2012 to 2021, this review summarizes the relationship between socioeconomic status and all-cause mortality in different metrics and the intermediate mechanism of the impact of socioeconomic status on all-cause mortality, so as to provide insights for further studies.

Currently,although surgical aortic valve replacement (SAVR) is still the golden standard in treatment of severe aortic stenosis according to the guideline,transcatheter aortic valve implantation (TAVI) is gradually becoming a common treatment for patients who are prohibitive or in high risk for SAVR.Recently,the valve manufacturers,including medical companies in China,are making their utmost to develop valve device,leading remarkable results achieved by TAVI.With the complications being controlled,TAVI displays promising future.It is likely that TAVI is expected to become a substitute for SAVR to treat patients with aortic stenosis or even aortic regurgitation.

Objective The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) as comparing with conventional coronary artery bypass grafting(CCABG) remain inconclusive in randomized, controlled trials and retrospective studies. We tried to assess the incidence of myocardial infarction (MI) after OPCAB and CCABG. with a meta analysis based on published data in randomized ,controlled trials. Methods Relevant randomized controlled trials, published in English and Chinese before January 2009, were searched in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. Manual searching of bibliographies were performed, with key words "oronary artery bypass graft", "off-pump" and "myocardial infarction". Two reviewers selected eligible trials independently, performed quality assessment and collected relevant data. Meta-analysis was performed with software RevMan 5. Results 22 trials were considered to be eligible for the meta analysis. The incidence of MI was 2.81% (42/1494) in the OPCAB group as compared with 3.57% (54/1512) in the CCABG group. No significant difference was present between the two groups (OR =0.80,95% CI =0.54 - 1.20, P =0.28). Conclusion Our meta analysis of current available randomized controlled trials involving OPCAB and CCABG in patients with coronary artery diseases suggests that the difference in the incidence of postoperative MI between CCABG and OPCAB groups is not significant.

Objective To evaluate the reliability and validity of the Chinese version of the Newest Vital Sign(NVS). Methods The NVS was translated and back-translated. Cultural adaption of scale was performed by Delphi expert consultation and pilot study. The reliability and validity of the Chinese version of the NVS was tested in 451 Chinese residents. Results Chinese version of the NVS consisted of 6 items with Pearson correlation between item and total score of scale ranging from 0.50 to 0.71. Two factors were abstracted by exploratory factor analysis and explained 61.51% of total variance. Confirmatory factor analysis showed that the fitness of the model was acceptable:comparative fit index was 0.96, Tuker-Lewis index was 0.92, standardized root mean square residual was 0.04, root mean square error of approximation was 0.077. Cronbach α coefficient was 0.71, retest reliability was 0.92. Conclusions Chinese version of the NVS has good reliability and validity, which can be used to test the health literacy of residents in China.

Objective:To introduce a novel surgical technique for dissecting perforator vessels (orderly retrograde four-side dissection) in anterolateral thigh perforator flap (ALTPF) and explore its clinical outcome.Methods:Respective analysis of 94 patients who underwent reconstruction of soft tissue defects with ALTPF which were dissected by orderly retrograde four-side dissection between June, 2013 and December, 2016. After surgery, the survival of flaps, recovery in shape and function of the recipient sites, and the effect on shape and function of the donor sites were observed.Results:The size of ALTPF ranged from 7 cm×5 cm to 32 cm×10 cm. Ninety-four perforators were included in 94 ALTPF, which were 89 perforators of the descending branch of circumflex femoral lateral artery, 4 perforators of the transverse branch of circumflex femoral lateral artery and 1 perforator of femoral medial artery. The time for flap harvesting was 35-95(54.39±16.39) min. Success rate of perforator harvesting was 98.9%, only 1 perforator was injured and another encountered vasospasm during surgery. Three cases had vascular crisis after flap transfer with 2 venous crises and 1 artery crisis. All of the flaps completely survived except 1 that had a partial necrosis. The follow-up time was (12.91±9.17) months. No muscular weakness on donor sites was shown in all cases.Conclusion:Orderly retrograde four-side dissection of perforator vessels in the ALTPF has achieved less donor site morbidity, shorter surgical time and is safer than the traditional techniques. It is a reliable technique to harvest perforator flaps.

A child who suffered a complex and exceptionally large soft tissue defects of both lower extremities and feet was referred in January, 2017. A debulking deep inferior epigastric perforator (DIEPF) was used to cover the defect in right shank. The defects in left shank and foot were reconstructed by latissimus dorsi flap and bilateral debulking anterolateral thigh perforator flap (ALTPF) . Two years after operation, the appearance and texture of both lower limbs were good, and the child could walk and run almost normally. There were slightly noticeable scars left in both thighs and the back.

Objective To explore the effect of self-care agency on frailty syndrome in hospitalized elderly patients.Methods A total of 102 hospitalized elderly patients were recruited by convenience sampling method and investigated by cross-sectional survey. The prevalence of frailty was evaluated by frailty phenotype, and socio-demographic characteristics scale and exercise of self-care agency scale were used to evaluated these patients.Results The prevalence of frailty syndrome were 31.4%(32/102). The total score of self-care agency scale was (104.38±20.20). Univariate analysis showed that the prevalence of frailty syndrome in elderly was statistically different in the age, household income, career, the number of chronic disease, the use of medication and self-assessment of health (P<0.05). Compared with no-frailty elderly, the self-care agency, especially self-worth of frailty syndrome patients reduced significantly(P<0.05). Multiple Logistic regression indicated that self-care skills (OR=0.775, 95%CI: 0.641-0.937) and self-worth (OR=0.585,95%CI: 0.424-0.807) were significant protective factors of frailty syndrome.Conclusions The poorer self-care skills and self-worth of the elderly, the higher prevalence of frailty syndrome. Raising the level of self-care agency actively can help to prevent or improve frailty syndrome.

Objective To investigate the relationship between health literacy and cognitive function in elderly inpatients.Methods A cross-sectional survey was conducted among 216 elderly people who were admitted to a class Ⅲ grade A hospital by convenience sampling. Social demographic characteristics scale, questionnaire on Chinese citizens' health literacy and minimum mental state examination were used in this survey.Results The health literacy score of elderly inpatients was (64.33±12.79) and the cognitive function score was(26.52±2.27). The scores of health literacy and cognitive function had moderate correlation in hospitalized elderly patients (r=0.52,P<0.05). The single factor analysis showed that the health literacy of the elderly inpatients was statistical different in the education level,the average monthly family income,occupation, chronic disease and cognitive function (P<0.05). The results of multiple linear regression analysis showed that educational level,cognitive function,occupational and chronic diseases were independent factors of health literacy among the elderly inpatients.Conclusions The cognitive function of elderly inpatients varies greatly, and the higher level of cognitive function is a protective factor for the health literacy of elderly inpatients. It is an important approach to improve health literacy among elderly patients in hospital by lowering the burden of cognitive function to communicate health information.