Objective To evaluate the dynamic characteristics of serum complement C1q, C3 and C4 levels in stroke patients over 85 years of age, and to analyze the effects of these indicators on the prognosis of cardiovascular events, and to explore its influencing factors. Methods A total of 320 stroke (AIS) patients admitted to our hospital from April 2017 to October 2020 were selected. Then, according to the prognosis of cardiovascular events (cardiovascular events and death, cardiovascular events but not fatal, no cardiovascular events), they were divided into 3 groups. At the same time, the serum of outpatients in the hospital was selected as a control. During treatment, 3 days after treatment, and 7 days after treatment, serum complement C1q, C3 and C4 levels were evaluated. The dynamic changes of serum complement C1q, C3 and C4 levels were determined by enzyme-linked immunosorbent assay. Results During the treatment, the levels of complement C1q, C3 and C4 showed a gradual decrease in 3 days after treatment and 7 days after treatment. Cardiovascular events occurred and died, and cardiovascular events occurred but not fatal. In the three groups of patients without cardiovascular events, serum complement C1q, C3 and C4 levels were significantly higher than those of the normal population. The levels of complement C1q, C3 and C4 in the cardiovascular event and fatal group were significantly higher than those in the cardiovascular event but not fatal group, and the complement C1q, C3 and C4 levels in the cardiovascular event but not fatal group were significantly higher than those in the non-cardiovascular event group , The differences between the two groups were statistically significant (P<0.05). Logistic regression analysis showed that the levels of complement C1q, C3 and C4 at the two time points after treatment can be used as independent factors influencing the prognosis of cardiovascular events (increased levels are risk factors). At the same time, the decreasing trend of complement level is a protective factor for the prognosis of adverse cardiovascular events. Conclusion Elevated serum levels of complement C1q, C3 and C4 in stroke patients over 85 years of age indicate a poor prognosis for cardiovascular events. Dynamic monitoring of serum complement C1q, C3 and C4 levels is of great significance to improve the prognosis of patients.

OBJECTIVE: To investigate the relationship between preoperative waiting time and prognosis of elderly patients with hip fracture. METHODS: From January 2014 to December 2018, 333 elderly hip fracture patients undergoing surgery were retrospectively analyzed, including 104 males and 229 females, aged from 60 to 99 years with an average of (77.93±8.49) years, and 183 patients were femoral neck fracture, 150 patients were femoral intertrochanteric fracture. Among them, 269 patients (80.78%) had a clustered preoperative waiting time of 2 to 8 days, and then divided into within 4-day group(91 cases) and over 4-day group(242 cases) according to their preoperative waiting time. The survival situation was followed by telephone, and follow-up time started from fracture admission to the death event, or to the research deadline (December 31, 2019). The Kaplan-Meier method was used for survival analysis, and Cox risk proportion model was used to analyze the independent risk factors of hip fracture in elderly patients. RESULTS: All patients were followed up for 12 to 75 months(means 35 months), 59 patients died and the mortality rate was 17.72%(59/333). Compared with within 4-day group, the mortality rate was higher in over 4-day group[20.66%(50/242) vs. 9.89%(9/91), χ²=5.263, P=0.022]. Multiariable Cox regression analysis showed that preoperative waiting time, age, male and Charlson comorbidity index were independent risk factors for the prognosis of hip fracture in elderly patients (all P<0.05), and every 1-day delay was associated with 5% increase of the risk of death[HR=1.05, 95%CI(1.00-1.10), P=0.045]. Subsequent analyse was stratified according to the Charlson comorbidity index (CCI), and found that over 4-day group had a higher mortality rate in patients with CCI<2, with statistically significant difference(P<0.05). CONCLUSION For elderly patients with hip fracture, most of hospitals could not complete the hip fracture surgery within 48 hours, we also need to shorten the waiting time before surgery, and thereby improve their prognosis.
Aged ; Female ; Femoral Neck Fractures ; Hip Fractures/surgery* ; Humans ; Male ; Prognosis ; Retrospective Studies ; Waiting Lists

【Objective】 To explore the safety of transrectal ultrasound-guided transperineal injection of sodium hyaluronate to expand the Dirichlet gap in laparoscopic radical prostatectomy. 【Methods】 A total of 14 healthy male purebred beagle dogs were selected and randomly divided into 2 groups, with 7 in either group.The control group was treated with conventional laparoscopic radical prostatectomy, while the experimental group was treated with laparoscopic radical prostatectomy after 2.5 mL sodium hyaluronate was injected into the Dirichlet gap under the guidance of transrectal ultrasound.The total operation time, prostate separation time, intraoperative blood loss and rectal status of the 2 groups were observed. 【Results】 After the injection of sodium hyaluronate into the Dirichlet gap between the prostate and the rectum, no rectal tissue was found in the prostate, and no obvious damage was found in the posterior rectum in either groups.The postoperative hemoglobin (HGB) was [(118.70±2.56) g/L vs.(122.10±2.19) g/L, P=0.02]; the total operation time was [(141.40±9.80) min vs.(119.10±9.16) min, P<0.05]; the prostate separation time was [(24.99±1.75) min vs.(16.64±2.34) min, P<0.05]; the amount of bleeding was [(47.43±4.32) mL vs.(34.86±5.18) mL, P<0.05] in the control group and experimental group. 【Conclusion】 Laparoscopic radical prostatectomy performed after 2.5 mL of sodium hyaluronate injection into the Dirichlet gap under the guidance of transrectal ultrasound can shorten the total operation time, the separation and resection time of the prostate, and reduce the amount of bleeding, which can improve and reduce the incidence of rectal injury, and prove the feasibility of this approach for prostatic cancer.

The author generally analyzed "Eight-Profiles" theory of traditional Chinese medicine before the Qing Dynasty, specifically, elucidated the meaning, theory origin, evolution and controversy of "Eight-Profiles" theory.

The article made a study on the earliest literature and the initial time of the "Five Orbiculi" theory in TCM. By analyzing the masons for different locations of "Five Orbiculi" recorded in ancient TCM books, the author argued against that the term of "Five Orbiculi" originated from ancient India and the "Five Orbiculi" theory was a product with the combination of traditioinal Chinese and Indian cultures. The author further put forward that the "Five Orbiculi" theory most probably was a Chinese traditional medical innovation under the influence of Internal Classic of Medicine, a great development to the theory recorded in Miraculous Pivot On Serious Confusion.

Objective To observe clinical effects of Guilong decoction combined conventional western medi-cine in the treatment of rheumatoid arthritis with cold-dampness syndrome.Methods 106 cases of rheumatoid arthri-tis with cold-dampness syndrome were randomly divided into the treatment group and the control group,with 53 cases in each group.The control group was orally given methotrexate and hydroxychloroquine,while the treatment group was given Guilong decoction based on the treatment of the control group.The clinical effects of the two groups were observed after a treatment course of 3 months.Results In the treatment group,35 cases were markedly effective, which was significantly higher than the control group(P <0.05);12 cases were effective,and there was no statistically significant difference with the control group (P >0.05).The total effective rate of the treatment group was 88.68%, which was significantly higher than the control group (χ2 =4.810,P =0.028).There were no significant differences of the adverse reaction ratio between the two groups(P >0.05).Conclusion Guilong decoction combined with con-ventional western medicine can obviously improve the rheumatoid arthritis disease severities,the curative effect is re-markable.It is worth popularizing in clinical application.

BACKGROUND AND PURPOSE: Dual antiplatelet therapy (DAT) with clopidogrel and aspirin has been shown to confer greater protection against early neurological deterioration (END) and early recurrent ischemic stroke (ERIS) than aspirin alone in patients who have experienced an acute ischemic stroke. However, few studies have compared the effects of anticoagulation therapy with low-molecular-weight heparin (LMWH), DAT, and aspirin. METHODS: Patients with acute ischemic stroke (n=1,467) were randomized to therapy groups receiving aspirin (200 mg daily for 14 days, followed by 100 mg daily for 6 months), DAT (200 mg of aspirin and 75 mg of clopidogrel daily for 14 days, then 100 mg of aspirin daily for 6 months), or LMWH (4,000 antifactor Xa IU of enoxaparin in 0.4 mL subcutaneously twice daily for 14 days, followed by 100 mg of aspirin daily for 6 months). The effects of these treatment strategies on the incidence of END, ERIS, and deep-vein thrombosis (DVT) were observed for 10-14 days after treatment, and their impacts on a good outcome were evaluated at 6 months. RESULTS: The DAT and LMWH were associated with a more significant reduction of END and ERIS within 14 days compared with aspirin-alone therapy. In addition, LMWH was associated with a significantly lower incidence of DVT within 14 days. At 6 months, DAT or LMWH improved the outcome among patients aged >70 years and those with symptomatic stenosis in the posterior circulation or basilar artery compared with aspirin. CONCLUSIONS: LMWH or DAT may be more effective than aspirin alone for reducing the incidence of END and ERIS within 14 days, and is associated with improved outcomes in elderly patients and those with stenosis in the posterior circulation or basilar artery at 6 months poststroke.
Aged ; Aspirin* ; Basilar Artery ; Constriction, Pathologic ; Enoxaparin ; Heparin, Low-Molecular-Weight* ; Humans ; Incidence ; Stroke* ; Venous Thrombosis

BackgroundThe mental health level of the prison police is relatively low， so finding innovative ways to improve the mental health of them is of great significance for the safety of prison supervision and the implementation of peaceful China initiative. ObjectiveTo explore the relationship between perceived social support， perceived stress and psychological resilience with mental health of prison police， and to provide references for improving their mental health. MethodsIn March 2022， 424 policemen working in a male prison in a western province were selected by cluster sampling method， and investigated with the Perceived Social Support Scale （PSSS）， Chinese Perceived Stress Scale （CPSS）， Connor-Davidson Resilience Scale （CD-RISC） and General Health Questionnaire 20 （GHQ-20）， then Process 4.2 was used employed to verify the mediating role of perceived stress as well as the moderating role of psychological resilience in the relationship between perceived social support and mental health. Results①Male subjects scored higher on GHQ-20 than female subjects （t=2.095， P<0.05）. ②CPSS score was negatively correlated with PSSS and GHQ-20 scores （r=-0.670， -0.703， P<0.01）， and GHQ-20 score showed a positive correlation with PSSS and CD-RISC scores （r=0.580， 0.693， P<0.01）. ③Perceived social support positively predict mental health （β=0.154， 95% CI： 0.133~0.175， P<0.01）. ④Perceived stress played a mediating role in the relationship between perceived social support and mental health， and the mediation effect size was 0.087， accounting for 88.78% of the total effect （95% CI： 0.064~0.112， P<0.01）. ⑤Psychological resilience played a moderating role in the second half （perceived stress→mental health） of the mediating path of "perceived social support→perceived stress→mental health"（β=0.074， 95% CI： 0.046~0.102， P<0.01）. ⑥Psychological resilience also regulated the mediation effect of perceived stress on the relationship between perceived social support and mental health ［three regression coefficients tested in turn are significant： a=-0.537 （95% CI： -0.594~-0.480， P<0.01）， b1=-0.162 （95% CI： -0.197~-0.127， P<0.01）， b3=0.074 （95% CI： 0.046~0.102， P<0.01）］. ConclusionPerceived social support of prison police has an impact on their mental health both directly and indirectly through perceived stress. In addition， perceived social support of prison police has a moderated mediation effect on mental health， and it is partially moderated by psychological resilience.［ Funded by General Project of Sichuan Prison Administrative Bureau in 2022］

【Objective】 To explore the risk factors of transfusion-related acute lung injury (TRALI). 【Methods】 The clinical symptoms, signs, imaging examinations, and laboratory test results of two patients with TRALI after blood transfusion were retrospectively analyzed, and human leukocyte antigen (HLA) genotyping of the patient and HLA antibodies typing of the plasma donors were performed. 【Results】 The clinical manifestations and laboratory parameters of two patients were consistent with those of TRALI after blood transfusion. After timely clinical respiratory support treatment, all patients were improved. Blood donors produced high titers of HLA-Ⅱ antibodies after pregnancy, including antibodies that specifically recognize the patient′s HLA antigen. 【Conclusion】 Two patients developed TRALI after platelet transfusion from a female blood donor, which was caused by HLA-Ⅱ antibodies.

OBJECTIVETo retrospectively assess serious systemic adverse effects of standardized dust-mite vaccine in children with asthma.

METHODSMedical records of 704 children (5-17 years in age) with asthma between January, 2005 and December, 2011 were reviewed. Serious systemic adverse events following treatment with a standardized dust-mite vaccine in these children were analyzed.

RESULTSA total of 336 systemic adverse reactions were observed in 17.0% (120/704) of the patients analyzed of these adverse reactions, 18 (5.4%) were serious (level 3), 318 (94.6%) were not serious (below level 3), and no single case of anaphylactic shock (level 4) was recorded. Systemic adverse events occurred most frequently in the 5 to 11-year age group and in the summer season (from June to August). In the 18 severe cases, the peak expiratory flow (PEF) dropped by 20% immediately after the vaccine injection, and other major clinical symptoms included cough, wheezing and urticaria. All children with serious systemic adverse effects were given inhaled hormone and atomized short-acting beta agonists, oral antihistamines, intravenous dexamethasone and/or intramuscular adrenaline. After these treatments, the clinical symptoms were significantly relieved.

CONCLUSIONSThe rate of serious systemic adverse events following allergen-specific immunotherapy is relatively low in children with allergic asthma. Conventional medications are effective in managing these immunotherapy-associated adverse events.

Adolescent ; Animals ; Asthma ; physiopathology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; adverse effects ; Female ; Humans ; Male ; Peak Expiratory Flow Rate ; Pyroglyphidae ; immunology ; Retrospective Studies ; Vaccines ; adverse effects