Objective Aortic dissection is accute in occurrence along with fast change , which is inclined to to induce psy-chotic symptoms and affect the lives of patients .The study was to investigate the effects of healthcare cooperative intervention on pa-tients with psychiatric symptoms secondary to aortic dissection . Methods We established medical cooperation organization structure to clarify the division of responsibility along with a quick assessment form , a process chart and a green channel for emergencey treat-ment.The above method was applied to intervene 32 patients with psychiatric symptoms secondary to aortic dissection and observe the diagnosis time , the time from diagnosis to surgery , the remission time of psychiatric symptoms , the incidence of adverse events and the length of stay. Results 32 patients were diagnosed within 30min followed by emergency surgery within 30min after diagnosis, which was 1-2 hours shorter than the previous diagnosis and surgery preparation time .5-21 d after surgery , psychiatric symptoms have been effectively controlled.Extubation, falling out of bed, self-injury or injury and other adverse events did not occur .No patient died, and the average length of stay was 13.5d, which was 1.75d shorter than the length of stay of previous similar patients . Conclusion The healthcare cooperation method can quickly identify patients with psychiatric symptoms secondary to aortic dissection , prevent adverse events and shorten the length of stay .

Objective The purpose of this study was to prepare RGD4C modified ferritin nanocages (RGD4C-FRT) for targeted drug delivery to rat hepatic stellate cells (HSC-T6). Methods RGD4C modified human H-chain ferritin was expressed and purified. Doxorubicin (Dox) was encapsulated into the cavity of RGD4C-FRT through ion channels, which resulted in RGD4C-FRT-Dox. The target of RGD4C-FRT-Dox to HSC-T6 was detected using fluorescence microscopy. Results Transmission electron microscopy showed that RGD4C-FRT was hollow spherical-structured with uniform size and good dispersion. The average particle diameters of RGD4C-FRT and RGD4C-FRT-Dox were 12.57 nm and 20.13 nm , respectively. The drug encapsulation efficiency and loading percentage of RGD4C-FRT-Dox were 77.32% and 15.88% respectively. RGD4C-FRT-Dox was significantly uptaken by HSC-T6, and the uptake could be blocked by the empty carrier RGD4C-FRT. Conclusion RGD4C-FRT-Dox can specifically target HSC-T6. Further animal experiments are needed to inspect its therapeutic effect on liver fibrosis.

Objective Because of the major trauma from thoracotomy , postoperative pain may arouse patients'psychological and physiological stress response and hence affected the treatment outcome and functional recovery seriously .We retrospectively studied the correlation between the staging of pain and nursing interference to investigate the effect of nursing interference on the pain intensity after thoracic surgery . Methods Five hundred and eighty cases of patients surviving thoracotomy between December 2013 and March 2014 in Nanjing Jingling Hospital were reviewed .Correlations between comfortable nursing measures such as effective analgesia , postural care , catheter care , environmental interventions , psychological intervention and the standard assessment of pain were analysed according to postoperative pain stage . Results With comprehensive nursing interference , the highest pain score occurred in the first 24 hour (2.89 ±0.39).The score was reduced gradually to 2.25 ±0.90 in stage Ⅱ, 1.58 ±0.57 in stage Ⅲ and 1.06 ±0.24 in stage Ⅳrespectively . Conclusion Comprehensive nursing interference according to pain staging may relieve pain effectively after thoracotomy .

BACKGROUND:The Y-shaped mesh graft material weaved using lightweight polypropylen has the appropriate porosity, which not only can make the vaginal tissues grow and fuse rapidly on the mesh, but also can maintain good biological strength to ensure the fixed strength for the presacral suspension. OBJECTIVE:To retrospectively analyze the clinical effect of Y-shaped mesh for the biological function reconstruction of the female pelvic floor. METHODS:Ten female cases of pelvic floor dysfunction were enrol ed, aged 37-73 years, and al were given the treatment of sacral colposuspension under laparoscopy. Then perioperative complications were recorded;patients were fol owed up regularly to record the Pelvic Organ Prolapse Quantification (POP-Q) score at different time points;and the subjective satisfaction was investigated using the Pelvic Floor Impact Questionnaire (PFIQ-7). RESULTS AND CONCLUSION:After at least 6-month fol ow-up, no postoperative pelvic infection, nerve damage and complications appeared, the patients healed wel , and no mesh erosion, infection and other adverse reactions occurred. The POP-Q and PFIQ-7 scores at 1, 3 and 6 months after repair were significantly improved than those before repair (P<0.05). These results suggest that the Y-shaped biological mesh repairing female midpelvic floor dysfunction has good biocompatibility, and can restore the anatomy of the pelvic floor.

Objective To compare the planning systems of the simplified manual intensity modulated (SMIM) irradiation and standard tangential (ST) irradiation,in order to explore the application of SMIM technique in clinic.Methods In 64 cases of breast cancers after breast conserving surgery,each underwent both SMIM and ST planning systems.SMIM planning was designed by copying additional fields for shielding the high dose areas from internal or lateral tangential field.The high dose areas were reduced by adjusting the size of the additional field and open tangential field.To optimize the SMIM planning,3 high dose areas (＞ 103% ,＞ 105% and ＞ 107%) were shielded and 3 protocols carried out.The wedges were also optimized in ST plan.The target coverage and dose homogeneity and dose of organ at risk were compared between SMIM and ST planning systems.Results When the dose was normalized to cover the volume of 95% CTV,85% of the shielded areas in optimal SMIM planning were that of ＞ 103% high dose area,and 94% of target area was covered.The study on the volume of breast CTV showed that,in the large breast group,SMIM could not only significantly reduce the high dose areas,and the maximum dose as well as the dose of organ at risk,but also enhance the dose homogeneity index.However,no such effect was not significant in the small breast group.Conclusions The simplified manual intensity modulated technique can improve target dose homogeneity in the large breast cases instead of the standard tangential technique.

[Objective] This study was designed to determine Th1, Th2 cell numbers and investigate T-bet mRNA, GATA-3 mRNA expression of spleen MNC in a mufine asthmatic model which intended to understand effect of airway T-bet plasmid gene transfer on Th differentiation. [ Methods] A mouse asthmatic model was established by sensitization with ovalbumin (OVA). Thirty-two C57BL/6 mice were divided into four groups (8 mice in each group): the normal control group (group A ), the asthmatic model group (group B), the pcDNA3 plasmid group (group C), the pcDNA3-T-bet group (group D). All animals were sensitized and challenged with OVA, except group A normal saline was applied. The group C was intranasally administered 50 μg pcDNA3 plasmid at 24 h before intranasal challenges, and the 50 μg pcDNA3-T-bet plasmid for the mice of group D. We investigated Th1 and Th2 cell numbers by FACS and T-bet, GATA-3mRNA expression of spleen mononuclear cells (MNC) by semi-quantitative PCR in the four groups. [Result] Th1 percent in spleen MNC of pcDNA3-T-bet treated mice was significantly increased ([2.29±1.551% vs. [1.93±1.141%, P<0.05), while Th2 percent was significantly decreased ([0.93±0.64]% vs. [1.63±0.59]%), compared with that of the asthmatic control group mice by FACS. Spleen MNC was detected a high level of T-bet mRNA expression (0.53±0.027 vs. 0.28±0.035, P<0.05) and a low level of GATA-3 mRNA expression (0.24±0.022 vs. 0.58±0.038, P<0.05) after pcDNA3-T-bet treatment by RT-PCR. There was no significant change between the pcDNA3 plasmid group and the asthmatic model group. [Conclusion] The intranasal transfer of pcDNA3-T-bet plasmid was effective in modulating the imbalance of Th1/Th2 in mice asthma model, which provides a novel therapeutic strategy for transferring transcriptional factor in allergic asthma.

Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.

Objective To use the superior sagittal sinus (SSS) as an example to identify anatomical features of the bridging veins(BVs) draining into the SSS in both susceptibility weighted imaging (SWI) and three dimensional contrast enhancement MR venography (3D-CEMRV) images.Methods A total of 20 healthy volunteers (40 sides) were examined in this study.The venograms of each patient was obtained from SWI (40 sides out of 20 volunteers) and 3D-CE MRV (40 sides out of 20 volunteers).The data were analyzed by t test.Results According to their draining location with respect to the SSS,bridging veins were devided into two groups.Between the anterior group and the posterior group were two segments of the SSS into which few bridging veins drained.Observed by 3D-CE MRV and SWI,the average numbers of the anterior group were 1.9 ± 0.6 and 3.2 + 0.8,respectively,and the average diameters of the anterior group were (3.4 ± 1.1 ) and (2.1 +0.5 ) mm,respectively.These differences between 3D-CE MRV and SWI images were significant ( t =11.23,9.76,P ＜0.0l ).Observed by 3D-CE MRV and SWI,the average numbers of the posterior group were 3.5 + 1.2 and 5.9 ± 1.1,respectively,and the average diameters of the posterior group were ( 3.7 ± 0.9 ) and ( 2.9 ± 0.7 ) mm,respectively.The differences between the two technique were significant as well ( t =11.51,8.47,P ＜ 0.01 ).Conclusion The dural entrance of BVs into the SSS can be identified in both SWI and 3D-CE MRV images.The preoperative venogram by using 3D-CE MRV and SWI is useful to design a individual-tailored surgical approach for the preservation of BVs draining into SSS.SWI outweighs 3D-CE MRV in identifying anatomical features of the dural entrance of BVs into the SSS.

Objective To investigate the prevalence of Vibrio parahaemolyticus(VP)in oysters in Jinshan District, Shanghai and make assessment on the risks that may cause, providing the basis for prevention and control of foodborne disease. Methods Raw oyster samples with shells were randomly collected from markets, supermarkets and restaurants in Jinshan District from July to October in 2017. The content of VP in oysters was tested in accordance with the national standard methods. The semi-quantitative risk assessment for VP in oysters was made by Risk Ranger combining with the monitoring results of diet and health status of residents in Jinshan District of Shanghai in 2012-2013. Results The overall positive rate of VP in the 40 oyster samples was 80.0%(32/40). The positive rate of VP in oyster samples from farmer's markets was the highest, 85.7%(12/14), followed by those from restaurants and supermarkets. The relative risk for VP in raw oysters was 63. The probability of illness caused by VP in oysters per day per consumer of interest was 6.85×10^-4, and the total predicted patients annual incidence rate in this population was 1 247.8/10⁵. Conclusion The contamination of VP in seafood oysters in Jinshan District is serious. Eating raw oysters is at high risk; consumers are advised to reduce or avoid eating raw oysters, and processing food before eating is an effective method to decrease VP infection. Strengthening surveillance and management is imperative in this regard.

OBJECTIVETo assess the methodological quality of systematic reviews or Meta-analysis of traditional Chinese medicine published in China, and to validate the applicability of OQAQ (Overview Quality Assessment Questionnaire) and AMSTAR (a measurement tool to assess systematic reviews) in traditional Chinese medicine (Chinese Medical).

METHODSComprehensive literature retrieve was performed in CBM, CNKI, VIP as well as hand searching in Chinese Journal of Evidence-Based Medicine. The retrieve was started from January 1, 1999 and terminated by December 2008. The methodological quality of traditional Chinese medicine correlated systematic reviews was evaluated using OQAQ and AMSTAR simultaneously.

RESULTSA total of 115 systematic reviews involved 17 types of diseases, of which, the cardio-/cerebrovascular diseases was dominant (36 papers, 31.30%). The mean OQAQ score was 2.50 (95% CI: 2.22, 2.76). No significant correlation was found in OQAQ score with publication year (P = 0.35) and different disease types (P = 0.28). High consistency was observed in evaluations of systematic reviews by using OQAQ and AMSTAR (both Kappa values > 0.75). Compared with the OQAQ, AMSTAR incorporated 3 additional items: the topics, publication bias, and conflict of interest, etc. Although 98.26% of systematic reviews proposed protocols in prior, 53.04% failed to analyze the publication bias. Besides, 57.39% neglected to address the potential conflict of interest.

CONCLUSIONSPoor methodological quality in systematic reviews of Chinese Medical published in China needs to be improved and emphasized. It is necessary to integrate the special characteristics of traditional Chinese medicine itself when choosing topics of systematic reviews. It is essential to establish quality assessment tools targeting systematic reviews of traditional Chinese medicine.