Objective To evaluate the diagnostic accuracy of transcranial doppler(TCD)as an additional screening tool for intracranial arterial steno-occlusive disease in patients with acute ischaemic stroke(AIS)by comparing with the computed tomography angiography(CTA). Methods Two hundred and twenty-four consecutive patients who were hospitalized within 7 days of the onset of symptoms and fulfilled the criteria for the clinical di-agnosis of AIS between May 2013 and May 2014 were enrolled for the study. Among the 224 patients,there were 118 males and 106 females with an average age of 61.2±12.6 years. High-resolution brain CTA was performed after completion of TCD. Results There was slight distinction of the diag-nostic accuracy of TCD for different arteries. TCD demonstrated the most accurate diagnosis for carotid artery vascular system,with a sensitivity of 96.19%and specificity of 98.60%. For the vertebrobasilar vascular system,TCD diagnosis showed a sensitivity of 71.11%and specificity of 94.31%. TCD findings were complementary to the CTA results(real-time embolization,collateral flow patterns and steal phenomenon). Conclusion TCD shows a high diagnostic accuracy comparing to CTA in evaluating intracranial and extracranial arterial stenosis in patients with AIS,especially for the carotid artery vascular system analysis within a short time interval. TCD can also provide additional real-time dynamic findings complementary to the information provided by CTA.

A total of 226 strains of organisms was isolated from the cultures of the subeschar unburnt tissues of the burn patients admitted to this institute in the period from April 1980 to April 1982. Among the organisms, gram-negative bacilli exceeded gram-positive cocci in number. The frequently seen gram-negative bacilli, in the order of frequency, were Pseudomonas, Serratia, Klebsialla, and E. coli. And the frequently seen gram-positive cocci were Staphylococcus aureus, Staphylococcus albus, Streptococcus fecalis, and Streptococcus hemolyticus.The quantitative culture of the biopsy specimen showed its value in our clinical application. In cases of multiple infections, after the identification and precise count of the bacterial colonies on the cultures were done, the percentage of the various organisms could be obtained and the main pathogen was revealed.It was pointed out that ordinary culture media were only favorable for rapid growth of bacteria but the existence of fungi was usually masked. A. modified method of fungus culture, tissue thread culture, was used for the early diagnosis of fungus infection. 38 specimens were studied simultaneously with three methods. The positive rate for fungus was 8% in ordinary cultures, 26% in his-tologic examinations, and 61% in tissue thread cultures.Anaerobic culture was performed for 102 swab specimens from the burn wounds and a positive rate of 14.7% was obtained. In addition, anaerobic blood culture was performed in 10 cases of severe burns with 2 positive cultures. It is suggested that anaerobic infections should not be neglected in burns.

Objective:To explore the safety and effectiveness of modified lower costa surgical approach (mLS) for transversus abdominis plane block (TAPB) combined with rectus sheath block (RSB) in surgical incision peritoneal dialysis catheterization (PDC).Methods:Forty chronic kidney disease of stage 5 patients scheduled for PDC from January to December 2018 in Huadu District People′s Hospital of Guangzhou City were selected. The patients were divided into 3 groups by random digits table method, among whom 13 cases used mLS for TAPB combined with RSB (TAPB combined with RSB group), 13 cases used lateral approach combined with hip approach for TAPB (TAPB group), and 14 cases used local anesthesia (LA group). The mean arterial pressure, heart rate and pain visual analogue score (VAS) at skin incision (T 0), separation of rectus abdominis (T 1), peritoneal dialysis catheter placement (T 2) and suture of skin and subcutaneous tunnel (T 3) were recorded; and the total operation and anesthesia time, cases of rescue anesthesia, surgeon′s satisfaction with anesthesia, surgical and anesthesia related complication were recorded. Results:The VAS from T 0 to T 3 in TAPB combined with RSB group and TAPB group was significantly lower than that in LA group: (1.92 ± 0.95) and (3.00 ± 1.08) scores vs. (5.07 ± 0.62) scores, (1.31 ± 0.63) and (2.54 ± 0.66) scores vs. (3.86 ± 0.77) scores, (0.85 ± 0.69) and (1.77 ± 0.93) scores vs. (3.71 ± 0.61) scores, (1.38 ± 0.77) and (1.38 ± 0.87) scores vs. (3.64 ± 0.17) scores, the VAS of T 1 in TAPB combined with RSB group was significantly lower than that in TAPB group, and there were statistical differences ( P<0.05). There were no statistical differences in mean arterial pressure and heart rate among 3 groups ( P>0.05). The surgeon′s satisfaction with anesthesia from T 0 to T 3 in TAPB combined with RSB group and TAPB group were significantly higher than that in LA group: (3.12 ± 0.76) and (3.11 ± 0.65) scores vs. (2.09 ± 0.61) scores, (3.09 ± 0.82) and (2.68 ± 0.75) scores vs. (1.99 ± 0.66) scores, (3.35 ± 0.82) and (3.31 ± 0.75) scores vs. (2.37 ± 0.73) scores, (3.02 ± 0.82) and (3.01 ± 0.75) scores vs. (2.35 ± 0.63) scores, surgeon′s satisfaction with anesthesia of T 1 in TAPB combined with RSB group was significantly higher than that in TAPB group, and there were statistical differences ( P<0.05). The rescue anesthesia in LA group was in 2 cases. The total operation and anesthesia time in TAPB combined with RSB group was significantly shorter than that in TAPB group and LA group: (45.08 ± 9.62) min vs. (74.46 ± 7.29) and (69.71 ± 13.25) min, that in LA group was significantly shorter than that in TAPB group, and there were statistical differences ( P<0.05). The patients of 3 groups had no surgical and anesthesia related complication. Conclusions:In surgical incision PDC with mLS for TAPB combined with RSB, the effectiveness of intraoperative anesthesia is accurate, the operation time is short, the surgeon′s satisfaction with anesthesia is high, the blood pressure and heart rate are stable, and the security is high.

Objective To evaluate the accuracy of presurgically resting-state fMRI(rs-fMRI) with subject order-independent group independent component analysis(ICA), compared to electric cortical stimulations. Methods Twenty-three patients with the lesion in motor area, which were recorded by our hospital from Jan, 2014 to Dec, 2015, were collected as the study sample. The data of 9 patients were excluded because of excessive head motion. As a result, 14 patients were included in this study. Rs-fMRI data before the surgery and the results of electric cortical stimulations were collected. Results All of this 14 patients were preoperatively located by rs-fMRI with SOI-GICA, including all the SMA and the ipsilesional primary motor area. On the side with lesion, the number of functional location of motor area was decreased compared with healthy side. Evaluate the accuracy of ICA by comparing the coincidence rate of these two techniques, based on the standardized electrical cortical stimulation in operation. The completely concordance between rs-fMRI with the SOI-GICA and electrical cortical stimulation in operation was 11 (11/14). Meanwhile the basically concordance of corresponded case was 3(3/14). Conclusions Rs-fMRI with the ICA has a relatively high accuracy rate in localizing motor area. Rs-fMRI has a remarkably referential contribution to the presurgically function assessment and surgical planning in implementation.

BACKGROUND:The incidence of high lumbar disc herniation in elderly patients with osteoporosis is increasing.The changes in lumbar overall mechanical strength and biomechanical properties of adjacent vertebrae after conventional posterior approach decompression and interbody fusion have not been clarified.Finite element analysis has great value in the field of biomechanics because of its advantages of non-invasiveness,high repeatability and accuracy. OBJECTIVE:To explore the establishment of a finite element model of senile osteoporotic L3/4 lamina decompression using finite element analysis and intervertebral fusion spine,and to evaluate the biomechanical status of the internal fixation complex of bones under bending motion in elderly patients with osteoporosis. METHODS:Mimics 21.0 was used to extract the DICOM data of the spine CT to establish the 3D bony structure of the lumbar spine(T12-L5),which was imported into Geomagic wrap 2017.The L3/4 full lamina decompression model was established after redrawing the mesh,deleting the nails,cutting the model,filling the cavity,detecting and editing the contour line,constructing curved surfaces and grids,fitting curved surfaces and other operations.Solidworks 2017 was used to construct pedicle screws,connecting rods,and intervertebral fusion cages,which were assembled into the L3/4 full lamina decompression model.Intervertebral discs and articular process cartilage and other structures were established through operations such as stretching,isometric surfaces,moving and copying entities.ANSYS Workbench 17.0 was utilized for material assignment,simulating spinal ligaments,meshing,applying force and limiting boundary conditions.A complete osteoporotic L3/4 laminar decompression and intervertebral fusion spine finite element model was established.The stress,strain and displacement cloud diagram of the L3/4 lamina decompression and intervertebral fusion full lumbar spine finite element model were observed under simulated bending conditions. RESULTS AND CONCLUSION:(1)In terms of the stress cloud diagram:The T12-L1 vertebra had the highest average stress value;L2 dropped by 24%;L3 dropped by 55%,and L4-5 dropped by about 80%.The stress concentration in the L4/5 articular process area was the highest,followed by L2/3,and lighter in L1/2 and T12/L1.The stress concentration at the junction of the screw and the connecting rod was obvious,followed by the screw at the entrance and exit of the pedicle.(2)In terms of strain and displacement cloud map:The strain degree of L4/5 and L2/3 articular process was the highest;the strain degree of T12/L1 and L1/2 was the second,and the L3/4 segmental fusion cage,pedicle screw and connecting rod had no any visible deformation.The intervertebral discs of all segments showed great deformation.(3)It is concluded that the cooperative operation of multiple software can successfully construct a finite element model of the spine with L3/4 lamina decompression and intervertebral fusion in elderly patients with osteoporosis.Elderly patients after lumbar spine surgery can tolerate forward flexion,confirming that L3/4 laminar decompression and intervertebral fusion can maintain the shape of the spine and ensure the stability of the spine,but it is necessary to be alert to the occurrence of thoracolumbar stress fractures and adjacent spondylopathy.

Objective To study the effect of aralia total saponins on renal function of type 2 diabetic mice, and its effect on the Bax and Bcl-2 protein in renal tissues, in order to provide some references for the development of aralia total saponins. Methods The mice were divided into the normal group, model group, positive control group, low, medium and high dose aralia total saponins group by random number method. Except the normal group, the others were received with high-fat diet for one month+one-time large dose of streptozotocin (STZ) to induce type 2 diabetic model, and then the mice in the normal group and the model group were intragastrically administered with the same volume of normal saline, and the mice in the positive control group was given 1 mg/kg of benazepril solution, and the low, medium and high dose groups were given 30, 60, 120 mg/kg aralia total saponins. The body weight of 1 ml/kg mice was intragastrically administered once a day. After treatment for 6 weeks they were sacrificed, and the serum insulin, and SOD and MDA levels were measured, the urine creatinine (Cr), urea nitrogen (UN), and uric acid (UA) levels were also measured. The immunohistochemistry and Western blot were used to detect the Bax and Bcl-2 protein expression in kidney tissues. Results Compared with the model group, the blood glucose and insulin resistance index in the low, medium and high doses aralia total saponins group were significantly decreased (P<0.05); the levels of urine UN, Cr and UA significantly decreased (P<0.05); The serum SOD level increased and the MDA level significantly decreased (P<0.05). The average gray value of Bcl-2 increased (92.26 ± 11.36, 107.17 ± 9.26, 132.65 ± 8.45 vs. 56.42 ± 16.24) in kidney tissue. The average gray value of Bax (152.62 ± 9.86, 124.48 ± 10.36, 92.29 ± 10.10 vs. 171.38 ± 15.18) significantly decreased ( P<0.05); Bax protein (0.81 ± 0.06, 0.75 ± 0.07, 0.52 ± 0.09 vs. 2.02 ± 0.09) significantly decreased, but Bcl-2 protein (0.92 ± 0.08, 0.94 ± 0.12, 1.27 ± 0.07 vs. 0.30 ± 0.09) significantly increased (P<0.05). Conclusions The aralia total saponins can reduce blood sugar levels, meanwhile improve renal function in type 2 diabetic mice. The mechanism may be may be that aralia total saponins could improve the antioxidant capacity and inhibition of renal cell apoptosis.

Objective:To investigate the characteristics of cardiac structure and function changes in maintenance hemodialysis (MHD) patients.Methods:The information of 363 MHD patients with dialysis age ≥3 months who were registered in Huadu District People′s Hospital of Guangzhou City before January 2020 was collected, and the echocardiographic screening was performed to analyze the changes in cardiac structure and function.Results:The most common abnormal changes of heart structure and function in MHD patients were valve regentation (69.7%), left ventricular hypertrophy (LVH) (51.8%), left ventricular diastolic dysfunction (29.8%), valve calcification (11.6%), and left ventricular systolic dysfunction (10.2%). With the increase of age, the left ventricular ejection fraction of MHD patients decreased, and the proportion of left ventricular diastolic dysfunction, left atrial enlargement and pulmonary hypertension increased (all P<0.05). Among 363 MHD patients, 188(51.8%) had LVH. It was found that LVH patients had higher average single ultrafiltration volume, higher brain natriuretic peptide (BNP) level, more type 2 diabetes, lower left ventricular ejection fraction (all P<0.05), and were more prone to chest tightness, chest pain, post activity shortness of breath, heart failure and other symptoms compared with the non-LVH patients (all P<0.05). Conclusions:Most MHD patients have different degrees of cardiac structural changes. Early intervention, reduction of single ultrafiltration volume and control of blood glucose are beneficial to improve the dialysis quality of MHD patients and reduce the occurrence of cardiovascular events.

OBJECTIVE： To prepare Ganshen granules， formulate its quality standards primarily and establish its HPLC fingerprint. METHODS： Using feeding speed， roller speed， roller pressure and roller clearance as factor， grain forming rate as index， single factor test and orthogonal test were used to optimize the granulation technology of Ganshen granules. According to 2015 edition of Chinese Pharmacopeia （part Ⅳ） （shorted for pharmacopeia）， moisture， granulation and dissolution were determined. TLC was used for the qualitative identification of Lycium barbarum， Astragalus membranaceus， Codonopsis pilosula in the Ganshen granules. HPLC method was used to determine the contents of betaine， calycosin-7-glucoside and lobetyolin in Ganshen granules. Fingerprints of 10 batches of Ganshen granules were drawn. RESULTS： The optimal dry granulation technology of Ganshen granules included that 25 r/min feeding speed， 8 r/min roller speed， 7 MPa roller pressure and 1.1 mm roller clearance， The grain forming rate is 85.83％. The moisture， granulation and solubility of Ganshen granule were all in line with pharmacopeia standard. TLC of L. barbarum， A. membranaceus and C. pilosula showed the same color spots on the corresponding positions of the reference chromatogram. The linear range of sample mass of betaine is 4.32-8.64 μg， and the linear range of mass concentration of calycosin-7-glucoside and lobetyolin were 5-30 and 10-60 μg/mL， respectively. RSDs of precision， reproducibility and stability tests （24 h） were all lower than 2.0％ （n＝5）. Average recoveries were 97.02％， 99.25％ and 101.04％ （all RSD＜1.7％， n＝6 or n＝9）. The contents of them were 4.298、0.054、0.025 mg/g， respectively. The similarity of HPLC fingerprints of 10 batches of Ganshen granules to control fingerprint was higher than 0.95. CONCLUSIONS： The optimal granulation technology of Ganshen granule is stable and feasible， and established quality standard and HPLC fingerprint can provide reference for quality control of Ganshen granule.

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) has had a massive impact on public health, resulting in sudden dietary and behavioral habit changes. Frontline epidemic prevention workers play a pivotal role against COVID-19. They must face high-risk infection conditions, insufficient anti-epidemic material supplies, mental pressure, and so on. COVID-19 seriously affects their dietary and behavioral habits, and poor habits make them more susceptible to COVID-19. However, their baseline dietary and behavioral habits before COVID-19 and their willingness to change these habits after the outbreak of COVID-19 remain unclear for these workers in China. This study aimed to explore the baseline dietary and behavioral habits of frontline workers and their willingness to change these habits after the outbreak of the epidemic; in addition, susceptible subgroups were identified by stratified analyses as targets of protective measures to keep them from being infected with COVID-19. METHODS: A cross-sectional study was conducted through an online questionnaire using a sample of 22,459 valid individuals living in China, including 9402 frontline epidemic prevention workers. RESULTS: Before COVID-19, 23.9% of the frontline epidemic prevention workers reported a high-salt diet, 46.9% of them reported a high frequency of fried foods intake, and 50.9% of them smoked cigarettes. After the outbreak of COVID-19, 34.6% of them expressed a willingness to reduce salt intake, and 43.7% of them wanted to reduce the frequency of pickled vegetables intake. A total of 37.9% of them expressed a willingness to decrease or quit smoking, and 44.5% of them wanted to increase sleep duration. Significant differences in the baseline dietary and behavioral habits and the willingness to change their habits were observed between frontline epidemic prevention workers and other participants. Among the frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19, frontline epidemic prevention experience was a promoting factor for adopting worse dietary and behavioral habits, including those in the high-salt intake subgroup (OR, 2.824; 95% CI, 2.341-3.405) and the 11-20 cigarettes/day subgroup (OR, 2.067; 95% CI, 1.359-3.143). CONCLUSIONS The dietary and behavioral habits of frontline epidemic prevention workers were worse than that those of other participants before COVID-19. They had a greater willingness to adopt healthy dietary and behavioral habits after experiencing the outbreak of COVID-19. However, frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19 continued in engage in these poor habits. Dietary and behavioral intervention policies should be drafted to protect their health, especially frontline epidemic prevention workers with poor habits at baseline.
Adult ; COVID-19/psychology* ; China/epidemiology* ; Cross-Sectional Studies ; Diet/standards* ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Health Personnel/psychology* ; Humans ; Male ; Risk Reduction Behavior ; SARS-CoV-2 ; Surveys and Questionnaires