BACKGROUND: The intelligence retardation in children refers to hypo-intelligence structure of full intelligence quotient(FIQ) composed of performance intelligence quotient(PIQ) and verbal intelligence quotient (VIQ) . It is verified in some researches that some of compound formulas provide better intervention on it.OBJECTIVE: To observe the effect of yizhi koufuye on intelligence structure in children with intelligence retardation.DESIGN: Homochronous controlled study based on children.SETTING: Pediatric department in a provincial college of traditional Chinese medicine and one provincial rehabilitation center.PARTICIPANTS: The cases were selected in Rehabilitative Central Hospital in Gansu Province and Clinic of the Hospital Affiliated to Gansu College of Traditional Chinese Medicine from January to July 2002. They were 74 students in Fudu Schools in Chenguan District, Lanzhou City, aged varied from 6 to 16 years, diagnosed as intelligence retardation according to CCMD-Ⅱ-R proposed Intelligence Retardation Diagnostic Standards, and they were able to accept medical and training treatment and were absent of congenital hereditary chromosome disorders. Of those, 47 cases were males and 27 cases females. They were divided into treatment group of 33 cases,the control of 20 cases and simple educational training group of 21 cases.METHODS: In treatment group of 33 cases, yizhi koufuye was administrated and was taken 15 mL each time for children younger than 10 years old, 20 mL for those between 10 to 14 years old and 25 mL for those over 14years old. In addition, the special educational training was applied. In the control of 20 cases, oral application of piracetam was prescribed, 0.4 g per time, 3 times a day and the special educational training was applied additionally. In simple educational training group of 21 cases, the children only received special education same as those in treatment group and the control. Three months made one session. Chinese-Wechsler Intelligence Scale for Children (C-WISC) and specific devices were used to assess FIQ and PIQ and VIQ in classified IQ in 3 groups before and after treatments, and the control comparisons were carried on among groups.MAIN OUTCOME MEASURES: Improvement of FIQ and improved values of VIQ and PIQ in 3 groups.RESULTS: Totally 74 cases were selected and no one lost. Improvement of FIQ: In treatment group, there were 44.7±9.8 and 51.8 ± 11.5 before and after treatment respectively, t = 2. 701, P ＜ 0.01; In the control, there were 43.8 ± 14.0 and 51.0 ± 13.6 before and after treatment respectively, t = 1. 680, P ＞ 0. 05; In simple educational training group, there were 41.6 ± 7.8 and 45.2 ± 10.6 before and after treatment respectively, t = 1. 561 and P ＞ 0.05. Improved values of VIQ: It was 8.1 ± 5.5 in treatment group, 5.3 ± 3.9 in the control and 4. 8 ± 4. 8 in simple educational training group. P ＜ 0.05 compared with the results in treatment group. Improved values of PIQ: It was 4.0 ± 3.6 in treatment group and P ＜ 0. 05 compared with 1.7± 2. 2 in the control and simple educational training group. Improving extent of VIQ was 8. 1 ± 5. 5 and of PIQ was 4.0 ± 3.6 in treatment group, P ＜ 0. 01.CONCLUSION: Yizhi koufuye improves markedly FIQ of children with intelligence retardation and for the classified IQ, the improving extent of VIQ is superior to that of PIQ.

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.

Objective To evaluate correlation of radial head fracture with forearm interosseous membrane (IOM) injury.Methods Twenty-six patients with radial head fractures were studied prospectively between September 2007 and June 2010.There were 15 men and 11 women,with an average age of 37.6years (range,21-53).According to the Mason classification,there were 7 cases of type Ⅰ,9 cases of type Ⅱ,10 cases of type ⅢL All patients were subjected to forearm X-ray,CT scans and the MR within a week.Clinical and radiographic data of all the patients were collected.Spearman rank correlation statistical analysis was used to analyze the correlation between the radial head fracture and the IOM injury.Results The radial head fractures and IOM injury were directly related.The IOM injury was noted in all type of radial head fracture.The more severity radial head fracture had,the more IOM injury happened.In Mason Ⅰ-Ⅲ fractures,IOM injury was found in 2,4 and 7 cases respectively.The different degree of radial head fracture caused different effects on IOM injury.The severity of radial head fracture was correlated with damage degree of IOM.In Mason type Ⅰ and type Ⅱ fractures,the IOM injury were just partial disruption with distal part of the IOM and did not reach the biomechanically essential central band.In type Ⅲ fractures,central band disruption was found in 3 cases.Conclusion Mason Ⅰ-Ⅲ radial head fractures are associated with forearm IOM injury.There was a positive correlation between radial head fractures and IOM injury.If IOM lesions are suspected,magnetic resonance imaging should be performed,especially Mason Ⅲ fractures.

Objective: To systematically review the barriers and facilitators affecting the implementation of clinical pathways for the clinical pathways. Methods: PubMed, Embase, CNKI, CBM, Wanfang, Cvip databases were searched to collect articles about clinical pathways implementation barriers and facilitators from inception to January 4th, 2019. The tool of confidence in the evidence from reviews of qualitative research(CERQual)was used to grade the confidence of each study. Results: A total of 43 articles from 12 countries were included.There were 8 main categories and 31 subcategories of the barriers about clinical pathways, including content of the clinical pathways, negative outcomes of clinical pathways, physicians knowledge, physicians attitude, resource availability, implementation of activities, patients factors and social factors. The first three barriers of high confidence were lacking of time, capital, equipment, staff and other resources(15 articles, 34.9%), increasing workload(14 articles, 32.6%), unrecognizing pathways(12 articles, 27.9%). There were 6 main categories and 28 subcategories of the facilitators about clinical pathways, including pathways content related, physician related, resource factor and implementation activity. The first three facilitators of high confidence were communication, education and training(25 articles, 58.1%), supporting from managers and colleagues(21 articles, 48.8%)and establishing a clinical pathway facilitation committee(17 articles, 39.5%). Conclusions The successful implementation of clinical pathways connects with its development process, aftereffect evaluation and feedback. It will be implemented effectively only by the completely and environmentally acceptable pathways design, adequate resources, effective organizational activities, continuous audit, evaluation and feedback and physicians active cooperation.

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post-exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization′s position paper on rabies vaccine in 2018 and related research progress in recent.