OBJECTIVE:To provide reference for rational use of TCM injection in the clinic. METHODS:In retrospective survey,the application of TCM injections in 3 hospitals from Changshu area during 2013-2015 were analyzed statistically in re-spects of consumption sum,annual growth rate,constituent ratio,DDDs,B/A,DDC,etc. RESULTS:During 2013-2015,in the sample hospitals,consumption sum of TCM injections in 2014 and 2015 declined by 5.27% and 15.92%,compared with last year. The proportion of consumption sum of TCM injections in total consumption sum were 4.40% in 2013,3.86% in 2014 and 3.13%in 2015. Top 3 TCM injections in the list of consumption sum and DDDs were blood activating and stasis eliminating drugs,the re-suscitation and reviving yang first aid class drugs and tonic drugs. The top single types in the list of consumption sum were Xing-naojing injection,Shuxuetong injection,Xuebijing injection,Shenmai injection and Xue shuantong for injection;the top single types in the list of DDDs were Shenmai injection,Reduning injection,Shuxuetong for injection,etc. B/A of Shenmai injection and Reduning injection were higher,while DDC of Xuebijing injection was the highest. CONCLUSIONS:The utilization of TCM injec-tion is basically reasonable,and shows decreasing tendency in sample hospitals,but great importance should be attached to the safe-ty and effectiveness of TCM injections and reasonable choice.

Objective To study the applied value of MR diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)value in chronic kidney disease(CKD).Methods 10 healthy volunteers and 45 patients with different period of CKD underwent routine MRI and DWI.The DWI features were observed.The ADC values were acquired by using Philips soft package on the ADC images.Results Under different b value(300 s/mm2,500 s/mm2 and 800 s/mm2),the ADC value of CKD were 2.29?0.27,2.07?0.21 and 1.91?0.22,respectively,which were significantly lower than that in normal kidneys,and there was statistical difference between different group of CKD.Conclusion DWI may be a noninvasive method to evaluate the renal function.

Recent related researches pointed out that a series of adverse reactions may occur when homocysteine (Hcy) level exceeded normal range .More and more studies indicated that Hcy level abnormal elevating was an inde‐pendent risk factor for cardiovascular diseases .This article summarized its related research situation .

Objective To explore the effect of auricular-plaster therapy combined with aromatherapy on anxiety and quality of life in patients with colorectal surgery.Methods A total of 135 patients with colorectal surgery were randomly divided into group A (auricular-plaster therapy combined with aromatherapy),group B(auricular-plaster therapy),group C (aromatherapy),group D(blank).Anxiety and life quality levels of four groups were determined by using self-rating anxiety scale(SAS),quality of life instruments for cancer patients (QLICP-CR)and were compared between four groups before and after intervention.Results The SAS and QLICP-CR scores of group A were lower than those of group B,group C and group D after intervention.The SAS and QLICP-CR scores of group B and group C were lower than that of group D after intervention.There were no statistical significant differences in SAS and QLICP-CR scores between group B and group C after intervention.Conclusions Auricular-plaster therapy combined with aromatherapy can effectively alleviate anxiety of patients with colorectal surgery and improve their quality of life,and the effect is better than that of auricular-plaster therapy and aromatherapy.

OBJECTIVE:To analysis the distribution and antibiotic resistance of common isolated pathogenic bacteria in urinary-tract infection cases in our hospital so as to provide scientific basis for the rational clinical use of antibacterials.MET-HODS:625 urine samples were collected from urinary-tract infection cases in our hospital in 2006,from which,344 strains of bacteria were isolated,which were cultured and subjected to drug sensitivity test.RESULTS:Of the 344 strains of bacteria,Gram-negative bacilli took the lead,accounting for 60.2% of the total,followed by Gram-positive cocci(33.4%) and fungi(6.4%).The detection rates of ESBLs-producing Escherichia coli.and Klebsiella pneumoniae were 49.2% and 27.3%,respectively.The bacteria had different resistant rate to different antibiotics and were multidrug resistant.CONCLUSION:Bacterial culture of urine and drug-sensitivity test should be performed promptly and drugs should be used with prudence for urinary infection cases to reduce drug-resistance bacteria.

Objective To assess the non-invasive and quantitative value of diffusion tensor imaging (DTI)in the diagnosis,differ-ential diagnosis and classification of renal occupying lesions.Methods 30 healthy volunteers and 126 suspected cases with renal space-occupying lesions underwent conventional magnetic resonance imaging (MRI)and DTI scans.A total of 144 lesions were found in 126 patients.DTI was performed in 6 directions with b values of 0 and 500 s/mm2 .Fractional anisotropy (FA)and appar-ent diffusion coefficient(ADC)values were measured.Results With b values at 500 s/mm2 ,FA and ADC values between the nor-mal renal cortex and medulla in renal carcinoma,renal angiomyolipomas,renal cysts were pairwisely compared and there were all statistical difference (P <0.05).Difference of FA and ADC values between clear renal cell carcinoma and non-clear cell carcinoma was also significant (P <0.05).Conclusion FA and ADC values could distinguish benign from malignant renal tumour which may be helpful in the speculation of renal carcinoma pathological types.

Objective To assess the effect of stromal cell-derived factor 1 (SDF-1) on the migration of neural stem cells and recovery of lower limb function after spinal cord injury (SCI).Methods A modified version of Allen's method was used to establish a SCI model in each of 96 adult male Sprague-Dawley rats.They were then randomly divided into group A which received an injection of phosphate buffer solution,group B which received an injection of neural stem cells,group C which received a combination of SDF-1 and neural stem cells,and group D which received AMD3100 and neural stem cells 7 days after the modeling.The functioning of the hind limbs of all of the rats was assessed on the 7th,14th,21st and 28th day after the modeling.The rats were then sacrificed and frozen sections of their spinal cords were stained with hematoxylin-eosin (HE) and marked with CM-Dil under fluorescent light.Results An accumulation of fluorescing cells were observed in spine cords from both group B and C,with the counts of group B [(23.6 ±3.7),(18.9 ±5.6)and(15.2 ±4.3) respectively] at the day 14,21 and 28 after modeling significantly smaller than those of group C [(27.4 ± 4.7),(20.4 ± 5.2) and (18.3 ± 3.9) respectively].During the same period of time,the average BBB scores of groups B and C were significantly better than those of groups A and D.Moreover,the average score of group C was significantly higher than group B's at all time points.Conclusions Transplanted neural stem cells can migrate to the injured site,surviving and differentiating to promote the recovery of limb function in rats with spinal cord injury.SDF-1 can promote that migration and proliferation.Moreover,CXCR4 receptor's antagonist AMD3100 can significantly hinder neural stem cells' migration to the injured site on the spinal cord.

Objective:To construct a deep learning-based diagnostic system for gastrointestinal submucosal tumor (SMT) under endoscopic ultrasonography (EUS), so as to help endoscopists diagnose SMT.Methods:From January 1, 2019 to December 15, 2021, at the Digestive Endoscopy Center of Renmin Hospital of Wuhan University, 245 patients with SMT confirmed by pathological diagnosis who underwent EUS and endoscopic submucosal dissection were enrolled. A total of 3 400 EUS images were collected. Among the images, 2 722 EUS images were used for training of lesion segmentation model, while 2 209 EUS images were used for training of stromal tumor and leiomyoma classification model; 283 and 191 images were selected as independent test sets to evaluate lesion segmentation model and classification model, respectively. Thirty images were selected as an independent data set for human-machine competition to compare the lesion classification accuracy between lesion classification models and 6 endoscopists. The performance of the segmentation model was evaluated by indexes such as Intersection-over-Union and Dice coefficient. The performance of the classification model was evaluated by accuracy. Chi-square test was used for statistical analysis.Results:The average Intersection-over-Union and Dice coefficient of lesion segmentation model were 0.754 and 0.835, respectively, and the accuracy, recall and F1 score were 95.2%, 98.9% and 97.0%, respectively. Based on the lesion segmentation, the accuracy of classification model increased from 70.2% to 92.1%. The results of human-machine competition showed that the accuracy of classification model in differential diagnosis of stromal tumor and leiomyoma was 86.7% (26/30), which was superior to that of 4 out of the 6 endoscopists(56.7%, 17/30; 56.7%, 17/30; 53.3%, 16/30; 60.0%, 18/30; respectively), and the differences were statistically significant( χ2=7.11, 7.36, 8.10, 6.13; all P<0.05). There was no significant difference between the accuracy of the other 2 endoscopists(76.7%, 23/30; 73.3%, 22/30; respectively) and model(both P<0.05). Conclusion:This system could be used for the auxiliary diagnosis of SMT under ultrasonic endoscope in the future, and to provide a powerful evidence for the selection of subsequent treatment decisions.

Objective To investigate the effect of rehabilitation on memory deficits after acquired brain injury, to compare different training models of memory rehabilitation and to analyze the possible factors affecting memory rehabilitation. Methods 144 patients with acquired brain injury following memory deficits were randomly assigned to computer-assisted training group, face-to-face training group and control group. Both training groups were given memory-based cognitive training program once a day which sustained 30 minutes for 6 or 12 weeks. The instantaneous memory, short-term memory and long-term memory were evaluated and compared before and after training. The effect of gender, age, education, course, site of injury and coma time on training efficacy were analyszed as well. Results 6 weeks and 12 weeks at training, both computer-assisted and face-to-face training groups showed a significant improvement in memory abilities when compared to controls (P<0.01), with the former making more progress (P<0.01). Negative correlation was found between age and memory performance. Conclusion Effectiveness of memory rehabilitation is proven. 12 weeks training can significantly improve memory. Cognitive training using professional equipment is significantly more effective than the face-to-face training and should be recommended.

Objective By analysis of the key performance indexes of the clinical laboratory automation system, to clarify the advantage and optimize the comprehensive performance of the laboratory automation system.Methods Key performance indexes were Collected from January 2017 to April 2017 in biochemistry and immunoassay group of Clinical Laboratory of Shanghai Tong Ren Hospital.(1)The data were collected and compared by the before-and-after method,the starting time of the automation system and initial sample test were analyzed.(2)Key performance indexes were analyzed for the time of specimen registration,inspection,and reporting.(3)The specimen turnaround time(TAT)was analyzed based on two months operation of the laboratory automation system.In view of disadvantage of infectious assays, setting up priority sample absorption, then TAT performance was re-evaluated.(4)By the assessment of total serum dosage required in the automation system, the number of blood vacuum tubes were reduced reasonably.The pros and cons of laboratory automation system were analyzed and the potential improvement were proposed.Results (1)According to the sample peak shift forward,the system start time could move forward 30 minutes earlier.(2)With the adopting of railway logistics,the specimens were sent to the lab and the registration time was at 7:25 am,and the time required for specimen delivery was greatly reduced which made specimen test,report and audit time all moved forward accordingly.(3)Data has shown that specimen TAT declined dramatically based on the performance of the first two month operation of the automation system,biochemical items were shortened 2 h,and the immunoassay shortened 4 h,respectively.Moreover the trend keeps better gradually.With setting up priority absorption infectious tests,the TAT was improved greatly,TAT reduced the average by 40 min.(4)500 μl(including the sample in dead space of vacuum tube)were needed for all the 65 biochemical items included in the system, and 1 495 μl serum were used for the 28 immunoassay.As a result, a total of 2 000 μl serum will be enough for sample analysis by the system, which provided the feasibility to reduce 3 vacuum tubes averagely.Considering the current automation system does not include all the analysis items in our lab directory, a few tests remain to be performed on offline instruments respectively.The methodology for some infectious agents are different from previous method, therefore some test results may need a period of time for comprehensive clinical appreciation.Furthermore,due to the parallel connection of multiple instruments included in the system, more rigorous and frequent quality control becomes a necessity,which may rely on more strict quality control procedure to guarantee the quality.Conclusions The application of the automation system significantly enhanced the efficiency of clinical laboratory all round.In addition, by the quantitative indicators, it is possible to monitor the system operation performance real time, which may feedback and facilitate the improvement constantly,and result in auto confirmation the majority results,eventually.