Clinical data of 21 pregnant women with scrub typhus were analyzed retrospectively.They all had fever,13 of them with lymph nodes enlargement,12 with skin rashes,11 with eschar or ulcer,and 20 positive with Weil-Felix reaction.Oxytetracycline was given in 17 of them and other four were treated by azithromycin,with all cured.Seven of them gave natural childbirth at the 37th week of gestation,nine were aborted inductively,three aborted spontaneously and two delivered premature births.Scrub typhus was harmful to both pregnant women and their fetuses,early diagnosis and treatment are necessary for patients with it for avoiding exacerbation and reducing fatality.

Objective: To study the mechanism of Gengnianle Water-paste Pills in resisting climacteric aging. Methods: Rats were randomly divided into blank group, model group, high and low dosage groups of Gengnianle, positive control group. The climacteric rat model were established by ectomizing the bilateral ovaries. The E2, follicle-stimulating hormone (FSH), luteinizing hormone (LH), triiodothyronine (T3), thyroid hormone (T4), thyroid-stimulating hormone (TSH) were detected. Results: Compared with model group, in high dose of Gengnianle group, the levels of E2, T3, T4 increased and the levels of FSH, LH, TSH reduced. The effect of high dose of Gengnianle in improving the adjustment function of the thalamus-hypophysis-ovary axis and the thalamus- hypophysis-thyroid gland axis is better than that of positive control group (P

Objective To investigate whether fasting obestatin level is different in patients with impaired glucose tolerance or type 2 diabetes, and to explore the association between obestatin and lipid metabolism. Methods Eighty-four subjects without known diabetes were divided into three groups: normal glucose tolerance(NGT), impaired glucose tolerance (IGT) and type 2 diabetes (DM) Plasma obestatin levels were measured with a radioimmunoassay. The relationship between fasting obestatin levels and metabolic parameters was also analyzed. Results Fasting obestatin levels were lower in DM group [(2.82±0.78)ng/ml] and IGT group [(3.25±0.29)ng/ml] than in NGT group[(3.55±0.57) ng/ml, P＜0.01]. Triglycerides and low density lipoprotein cholesterol levels gradually increased among the three groups (P＜0.05). Multiple linear regression analysis revealed fasting obestatin level was independently associated with waist-to-hip ratio, triglyeride and low density lipoprotein cholesterol. The regression equation was obestatin=6.953-3.412×W/H-0.175×TG-0.123×LDL-C. Conclusions The decreased obestatin may be associated with IGR and T2DM, and obestatin level may be associated with lipid metabolism.

Objective: To study the clinical efficacy of Jianpijiangniling combined with chemotherapy for advanced non-small-cell lung cancer(NSCLC). Methods: A total of 129 patients were randomly assigned to the treatment group and the control group.All patients received four cycles of chemotherapy.Patients in the treatment group received concurrent four-cycle Jianpijiangniling therapy.Clinical curative effect，overall survival，quality of life，body weight，and side effects were analyzed. Results: No significant difference was found in the total efficiency between the two groups.Patients'quality of life and body weight in the treatment group were superior to those in the control group(P<0.05，P<0.01).Nausea and vomiting were more frequently seen in the control group than in the treatment group(P<0.05).No statistically significance was found in the rates of diarrhea，constipation，and other adverse effects between the two groups.Marrow suppression was frequently seen in the control group.The rates of leucopenia and decrease in hemoglobin were higher in the control group(P<0.05).The difference in the rate of thrombocytopenia between the two groups was not significant. Conclusion: Jianpijiangniling combined with chemotherapy is effective for advanced non small-cell lung cancer,with fewer side effects.

OBJECTIVETo establish a quantitative HPLC method for determination of protopine, palmatine hydrochloride, bicuculline and tetrahydropalmatine, in Corydalis decumbens.

METHODThe separation was performed on a ZORBAX Eclipse XDB-C18 column (4.6 mm x 150 mm, 5 microm) at a flow rate of 1.0 mL x min(-1) using mixtures of two solvents [A(20 mmol x L(-1) ammonium acetate)-B(acetonitrile)]: with a gradient elution. The column oven temperature was 30 degrees C and the detection wavelength was set at 280 nm.

RESULTThe 4 alkaloids were well separated by this HPLC method. Linearifies of protopine, palmatine hydrochloride, bicuculline and tetrahydropalmatine were good in the ranges of 1.44-46.0 (r = 0.999 4), 1.2640.2 (r = 0.999 8), 1.37-44.0 (r = 0.999 9), and 1.3643.6 mg x L(-1) (r = 0.999 9), respectively. The average recoveries were 98.2% with RSD 2.7% for protopine, 101.9% with RSD 2.5% for palmatine hydrochloride, 102.8% with RSD 3.5% for tetrahydropalmatine, and 98.8% with RSD 3.1% for tetrahydropalmatine.

CONCLUSIONThis method is proved to be convenient, reliable and accurate., and it can be used for quality control of C. decumbens.

Objective:To establish a new nurse standardized training management index system based on training transfer theory, and to provide reference for objective evaluation of standardized training management for new nurses.Methods:From August 2020 to April 2021, guided by the theory of training transfer, the standardized training management indexs for new nurses were preliminarily drawn up through literature review, semi-structured interviews. The Delphi method was used to conduct two rounds of expert consultation.Results:The effective questionnaire recovery rate of the two rounds of expert consultation was 92.00% (23/25) and 95.65% (22/23), respectively. The expert authority coefficients were 0.904 and 0.905, respectively. Kendall′s harmony coefficients were 0.228 and 0.250, respectively, both P<0.01. The final index system of standardized training management for new nurses based on training transfer theory included 4 first-level indexes, 14 second-level indexes and 59 third-level indexes. Conclusions:The new nurse standardized training management index system based on training transfer theory is scientific and reliable. It provides a tool for evaluating standardized training management of new nurses and a reference for perfecting the training management system of new nurses.

Objective:To describe the epidemiological characteristics of respiratory syncytial virus (RSV) infection in preschool children and explore the risk factors for severe pneumonia.Methods:Epidemiological data of 279 preschool children with RSV infection were investigated. The children were screened for severe pneumonia and separated into ordinary and severe types. General data and laboratory test data from both groups were compared, and binary logistic regression model analysis was applied to determine the risk factors for severe pneumonia.Results:Preschool children with RSV infection were mostly male (63.08%), <6 months old (65.95%) and had poor living environment (53.05%), with main symptoms of cough (91.04%) and wheezing (69.18%), the lung auscultation was mainly characterized by wheezing (86.74%), and imaging findings were mainly patchy shadows (76.34%), the onset season was concentrated in autumn (31.18%) and winter (43.37%). The detection rate of severe pneumonia in 279 pediatric patients was 20.27% (56/279). The proportions of onset season being autumn or winter, low birth weight infants, history of respiratory infections within 3 months, delayed treatment, neutrophils count <10×10 9/L, C-reactive protein≥10 mg/L, procalcitonin≥1.5 ng/mL, albumin<30 g/L, CD4 + /CD8 + <1.2 in the severe types were higher than those in the normal types ( P<0.05). Logistic regression analysis showed that the onset season was autumn or winter ( OR=2.316, 95% CI: 1.235-4.345), low birth weight infants ( OR=2.679, 95% CI: 1.442-4.977), history of respiratory infections within 3 months ( OR=2.815, 95% CI: 1.539-5.148), delayed treatment ( OR=2.869, 95% CI: 1.581-5.206), low albumin<30 g/L ( OR=2.756, 95% CI: 1.495-5.080), and low CD4 + /CD8 + <1.2 ( OR=3.016, 95% CI: 1.695-5.366) were risk factors for severe RSV pneumonia in preschool children ( P<0.05). Conclusions:Autumn and winter, low birth weight infants, history of respiratory infections within 3 months, delayed treatment, low albumin, and low CD4 + /CD8 + are related to the occurrence of severe RSV pneumonia in preschool children. Therefore, it is necessary to strengthen the attention to the condition of preschool RSV infected children with the above risk factors, and actively intervene in controllable factors to reduce the risk of severe pneumonia.

Objective?To explore the safety of hydrophilic fiber containing silver dressings used on the wound of the patient with pressure sore. Methods?From January 2014 to January 2017, 60 elderly patients with pressure sore from inpatient and outpatient of Geriatrics Department of Shenzhen People's Hospital were selected as the research object. They were divided randomly into control group and experimental group, 30 patients for each group. Patients in the experimental group used hydrophilic fiber containing silver dressings on half of the area of the wound. Patients in the control group used hydrophilic fiber containing silver dressings on the whole area of the wound. All the treatment lasted for 4 weeks. Silver concentration of serum, serum creatinine and alanine aminotransferase value were detected in two groups of patients. Data were analyzed by SPSS 17.0 statistical software. Results?After the use of hydrophilic fibers containing silver dressing, the silver concentration of serum in the two groups increased, the value reached a peak in the third week and a downtrend in the fourth week; There were no significant differences in silver concentration of serum between the two groups in the first 3 weeks (P＞ 0.05), but the difference was statistically significant only in the fourth week (P＜ 0.05). There were no significant differences between the serum creatinine and alanine transaminase in the two groups (P＞0.05). Conclusions?The usage of hydrophilic fibers containing silver dressing cannot directly affect serum creatinine and alanine transaminase within four weeks.

Aim To explore the mechanism of oxiracetam promoting neurogenesis and migration in rats with cer-ebral infarction through stromal cell-derived factor-1α(SDF-1α)/C-X-C chemokine receptor 4(CXCR4)pathway.Methods 100 SD rats were randomly divided into control group,cerebral ischemia(CI)group,oxiracetam(200 mg/kg)group,and oxiracetam(200 mg/kg)+AMD3100(5 mg/kg)group,with 25 rats in each group.Electrocoagulation was used to create rat model of local permanent cerebral infarction.After 1,7 and 14 days of modeling,neurological deficits were scored,TTC staining was used to detect the volume of cerebral infarction,Nissl staining was used to detect cell surviv-al in the infarcted area,Western blot was used to detect SDF-1α and CXCR4 protein levels in ischemic zone.After 1～7 days of modeling,BrdU(50 mg/kg)was continuously injected intraperitoneally.After 14 days,immunofluorescence double staining was used to detect the number of BrdU+Nestin+and BrdU+DCX+cells in the SVZ region.5 days before modeling,retroviruses carrying GFP were injected into the SVZ region.After 14 days,immunofluorescence double stai-ning was used to detect the number of GFP+DCX+,GFP+MAP-2+and GFP+GFAP+cells in infarction area.C17.2 cells were divided into control group,oxygen-glucose deprivation(OGD)group,oxiracetam(final concentration:200 mg/L)group,and oxiracetam(final concentration:200 mg/L)+AMD3100(final concentration:100 μmol/L)group.OGD was used to create cell CI model.After 12 hours,immunofluorescence double staining was used to detect the number of Br-dU+/Nestin+and BrdU+/MAP-2+cells,Transwell experiment was used to detect cell migration,Western blot was used to detect SDF-1α and CXCR4 protein levels in cell culture supernatant.Results Animal experiment results showed:compared with control group,mNSS score in CI group was increased,cerebral infarction volume was increased,the number of surviving cells in infarcted area was decreased,SDF-1α and CXCR4 protein levels were increased,the number of GFP+DCX+,GFP+MAP-2+and GFP+GFAP+cells in SVZ region were increased(P＜0.05);compared with CI group,mNSS score in oxiracetam group was decreased,cerebral infarction volume was decreased,the number of surviving cells in infarc-ted area was increased,SDF-1α and CXCR4 protein levels were increased,the number of GFP+DCX+,GFP+MAP-2+and GFP+GFAP+cells in SVZ region were increased,the number of GFP+DCX+,GFP+MAP-2+and GFP+GFAP+cells in in-farcted area were increased(P＜0.05);compared with oxiracetam group,mNSS score in oxiracetam+AMD3100 group was increased,cerebral infarction volume was increased,the number of surviving cells in infarcted area was decreased,CXCR4 protein level was decreased,the number of GFP+DCX+,GFP+MAP-2+and GFP+GFAP+cells in the SVZ region were de-creased(P＜0.05).Cell experiment results showed:compared with control group,the number of BrdU+/Nestin+and Br-dU+/MAP-2+cells in OGD group were increased,the number of cell migration,SDF-1α and CXCR4 protein levels in cell culture supernatant were increased(P＜0.05);compared with OGD group,the number of BrdU+/Nestin+and BrdU+/MAP-2+cells in oxiracetam group were increased,the number of cell migration,SDF-1α and CXCR4 protein levels in cell culture supernatant were increased(P＜0.05);compared with oxiracetam group,the number of BrdU+/Nestin+and BrdU+/MAP-2+cells in oxiracetam+AMD3100 group were decreased,the number of cell migration,CXCR4 protein level in cell culture supernatant were decreased(P＜0.05).Conclusion Oxiracetam may promote the migration of neural stem cells from the SVZ region to the ischemic zone,promoting neurogenesis and functional recovery in rats with cerebral infarction by activating SDF-1α/CXCR4 pathway.

Objective To analyze the clinical,radiological features and risk factors of diplopia in patients with acute lacunar infarction (ALI).Methods Retrospectively retrieved patients of ALI (lesion diameter was less than 1.5 cm in DWI sequence)diagnosed by MR and clinical.We further summarized 13 ALI patients with diplopia and randomly selected 13 ALI patients without diplopia as the control group. SPSS22.0 statistical software was used for statistical analysis.The general clinical data such as sex and age was compared by Ch-i square test and t-test.The risk factors were primarily analyzed by one-way ANOVA and then the risk factors with statistical significance were brought into the logistic regression model for multivariate analysis.Results The incidence of diplopia in ALI patients was about 2.7%(13/489). The infarct sites were all located in the brain stem of the oculomotor-related brain nucleus and the dorsolateral medulla oblongata.Hypertension and hematocrit were negatively correlated with diplopia after infarction (P＜0.05 ).Conclusion The incidence of diplopia is low in ALI patients.The medial longitudinal tract of the dorsolateral medulla is an important area causing diplopia.Hypertension and hematocrit are non-risk factors for diplopia after ALI.