Objective To evaluate the clinical result of system rehabilitation training on joint rehabilitation after operation in cruciate ligament injury of the knee joint patients.Methods All patients were followed up for 6～18 months(average 12.8 months).The clinical results were evaluated according to Lysholm and Lachman clinical rating scales.Results At the end of follow-up,there was no knee extension limitation and the knee flexion was between 110°and 150°,with an average of 130°.The Lysholm score of the 110 cases was (69.3±4.8) before operation, and (88.3±11.6) at the end of follow-up.The difference between the Lysholm scores was significant (P < 0.01), the difference of Lachman score below 4mm in 82 cases and 19 cases were below 5mm.Conclusion Early system rehabilitation training can relieve the postoperative pain and swelling of pain,and improve the function of knee joint in cruciate ligament injury of the knee joint patients.

In developing excellent courses on pediatrics,it is proved that improving teaching content and enhancing the building of the teaching staff,adopting effective theoretical and practical teaching and building a sound and guaranteed monitoring system of the teaching quality will have a better teaching effect.

OBJECTIVE:To provide reference for strengthening the management of drug off-label dosage in hospital. METH-ODS:PDCA cycle management was conducted to investigate the current situation of off-label dosage of Alprostadil injection (Li-po-PGE1)in endocrinology department of our hospital before Jul. 2012 in the Plan stage,identify problems,find reasons and devel-op intervention objectives and measures;after intervention in Do stage,medical advices were checked periodically in Check stage, and the data in the same stage of 2013 were spot-checked in Astage stage,intervention effect was analyzed and interventional pro-cess was standardized. RESULTS:Totally 943 medical advices,including 126 cases/times were analyzed before PDCA intervention and according to the data of cases,medical advices and drug usage amount,the incidences of off-label dosage were 39.68%, 31.50% and 47.90%,respectively;after a cycle of PDCA intervention,totally 414 medical advices,including 73 cases were ana-lyzed and the incidences of off-label dosage were 0. The prescribed daily dose(PDD)was decreased from 13.15 μg to the predeter-mined range(10.00 μg)with decrease rate of 23.95%;the drug use density(DUD)was decreased from 59.82 to 20.07 with de-crease rate of 66.45%. There were significant differences in among the incidence of off-label dosage,PDD and DUD of Lipo-PGE1 (P<0.05). It reached the expected targets. CONCLUSIONS:Because of its well-organized ideas on work and continuous improve-ment methods of circulation,PDCA cycle management provides a workable avenue to manage drug off-label dosage uses in hospital.

ObjectiveTo investigate the effect and mechanism of prostaglandin E2 (PGE2) in renin regulation at the juxtaglomerular apparatus (JGA). MethodsMacula densa cell line (MMDD1) was cultured on the special filter. In the medium on the apical lateral of the cells, low concentration of sodium chloride, chloride and different doses of angiotensin Ⅱ (Ang Ⅱ) were used to stimulate the PGE2 secretion. The PGE2 concentration was tested by ELISA. In the animal experiment, the response of plasma renin activity (PRA) to acute intraperitoneal administration of captopril (30 mg/kg) was determined, in conscious wild-type (WT) and cyclooxygenase COX-2-/- mice on C57BL/6 genetic backgrounds. PRA was measured in plasma obtained by tail vein puncture. Different concentrations of PGE2 were used to stimulate the renin secretion of primary cultured JGA cells from COX-2-/- mice and wild type mice. In specific Gsα gene delete mice (low renin producing mice), 24 h urine was collected to test the concentration of PGE2. The COX-2 mRNA and protein of the kidney cortex were observed by real-time PCR and immunohistochemicul staining. ResultsLow chloride could stimulate the PGE2 secretion both at the apical and basement of the macula densa cells. In COX-2-/- mice, the base PRA and were obviously lower than wild type mice. Captopril could stimulate the PRA of (COX)-2-/- mice increasing 32.8 times. But Ang Ⅱ had no effect on PGE2 secretion in macula densa cells. In primary cultured JGA cells, the decreasing renin seretion was partly recovered by PGE2 in cells from COX-2-/- mice. In low renin producing mice, the expression of COX-2 mRNA in the kidney cortex increased by (8.07±1.08) times (n=6, P=0.0022). The COX-2 protein of the kidney cortex and the urine PGE2 increased by several times. ConclusionsLow chloride is the primary stimulation messenger of PGE2 secretion in macula densa cells. The PRA in COX-2-/- mice can be stimulated by angiotensin converting enzyme inhibitor, but the Ang Ⅱ has no direct effect on macula densa cells. When renin production is abolished in JGA cells (Gsα delete mice), COX-2 mRNA and protein up-regulation is observed in kidney cortex and macula densa. PGE2 plays an important role in regulation of renin secretion and renin release in JGA by precise feedback mechanism.

Objective To investigate the diagnostic value of ADC histogram obtained from MR DW imaging for stage ⅠB cervical cancer. Methods Seventy three patients diagnosed by cervical smear screening as cervical cancer without priortreatment were included prospectively in the patient group, and staged according to the international federation of gynecology and obstetrics (FIGO) staging system. Forty three patients with uterine leiomyoma detected by gynecologic examination, ultrasonography or CT and with negative result of cervical smear screening who were scheduled for hysterectomy were included prospectively in the control group. The patients of both groups underwent routine pelvic MR sequences, dynamic contrast enhanced imaging and DWI before hysterectomy. ADC histograms of the entire tumor and cervix volume were generated by post-processing software. Features of ADC histogram for the 2 groups were observed. Histogram parameters such as mean ADC (ADCmean), median ADC (ADCmedian), the 25th percentile of ADC (ADC_25th), the 75th percentile of ADC (ADC_75th), skewness and kurtosis were recorded. Student's t test or Mann-Whitney U test depending on homogeneity of variance was employed for the comparison of
those parameters. ROC analysis was employed for assessing the diagnostic performance of ADC histogram in distinguishing the 2 groups. Results Thirty five patients in the patient group were staged as FIGO IB. Five patients in the control group ended up with pathologic findings of cervical intraepithelial neoplasia grade 3. Therefore 38 patients in the control group were investigated. ADC histograms of the patient group were mostly skewed positively, while the curves were largely skewed negatively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the IB stage patient group were (1.10±0.21)×10-3mm2/s, (1.05±0.21)× 10-3 mm2/s, (0.90 ± 0.19) × 10-3mm2/s, (1.26 ± 0.23) × 10-3mm2/s, 0.83 (median) and 1.25 (median) respectively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the control group were (1.62 ± 0.25)×10-3mm2/s, (1.64±0.24)×10-3mm2/s, (1.42±0.24)×10-3mm2/s, (1.84±0.27)×10-3mm2/s,-0.11(median) and 0.29 (median) respectively. All parameters showed statistically different (t values were -9.693,- 11.117, -10.255, and -9.988 for ADCmean, ADCmedian, ADC_25th and ADC_75th respectively;Z values were -6.360 and -4.445 for skewness and kurtosis respectively; P< 0.01). ROC analysis indicated that ADCmedian had the highest diagnostic accuracy for differentiating the 2 groups, with the area under the curve being 0.97, a cutoff value of 1.21×10-3mm2/s, and a sensitivity of 95.6%and a specificity of 89.3%. Conclusion ADC histogram of DWI may be valuable for diagnosing stage IB cervical cancer by distinguishing stage IB cervical cancer from normal cervix or cervical benign lesions.

OBJECTIVETo establish a new method for the identification of Schisandra sphenanthera and S. chinensis.

METHODRandom amplified polymorphic DNA-Sequence characterized applied region (RAPD-SCAR) method was applied to screen primers.

RESULTScreening from 100 primers, only 2 random primers, which can be used to identify S. sphenanthera and S. chinensis accurately with a good reproducibility. It worked to fit them into sequence characterized applied region.

CONCLUSIONRAPD-SCAR can be used to identify S. sphenanthera and S. chinensis accurately.

Randomized controlled trials (RCT) have long been considered the gold standard for assessing clinical efficacy. However, RCT are inappropriate for some diseases due to related ethical issues and costs, such as rare diseases that are seriously life-threatening but without adequate treatment. Using real world data (RWD) as external control for RCT could make recruitment less complicated and reduce time and cost. This paper introduces common application scenarios, data sources, study design, basic principles, and statistical methods of RWD as an external control based on the latest guidelines related to RWD and combined with our team's previous research experience. This study could provide references for scholars and sponsors who want to conduct RWD research.

Palliative care not only embodies modern life perspectives, but also encompasses significant traditional Chinese cultural elements.The primary objective of palliative care is to alleviate patient suffering, preserve their dignity, and facilitate a peaceful passing.Traditional Chinese medicine, known for its simplicity, accessibility, affordability, and efficacy in disease prevention and treatment, adopts a holistic approach to address systemic pain through personalized treatment based on symptom differentiation.This approach aims to enhance the quality of life for terminally ill patients.To equip palliative care providers with essential clinical skills in traditional Chinese medicine, the National Center of Gerontology and Beijing Palliative Care Guidance Center collaborated with experts and scholars to develop guidelines focusing on common end-of-life symptoms.Through extensive deliberation, expert evaluation, and revisions, this guidance document was crafted as a valuable resource for palliative care practitioners, traditional Chinese medicine clinicians, and researchers in the field.