OBJECTIVE:To determine the contents of heavy metals in commercial Chinese crude drugs and to provide reference for the monitoring of heavy metals in the crude drugs.METHODS:UV spectrophotometry was established to determine the contents of heavy metals in 6 vegetable drugs(Panax quinquefolium,Panax ginseng,Lycium barbarum,Radix et Rhizoma Glycyrrhizae,Bulbus Fritillariae Cirrhosae and Salvia miltiorrhiza)and 2 animal-source drugs(Scolopendra subspinipes mutilans and Bombyx Batryticatus).RESULTS:The linear range of heavy metal plumbum(reference substance)was 0.01～0.50 ?g?mL-1(r=0.997 7),and the average recovery rate was 99.49%(RSD=1.41%).The contents of heavy metals in Panax quinquefolium,Panax ginseng,Lycium barbarum,Radix et Rhizoma Glycyrrhizae,Bulbus Fritillariae Cirrhosae,Salvia miltiorrhiza were 26.13,28.96,26.99,29.98,26.63 and 28.06 ?g?g-1 respectively,and the contents of Scolopendra subspinipes mutilans and Bombyx Batryticatus were on the high side(47.62 and 59.24 ?g?g-1 respectively).CONCLUSION:The method is easy,highly accurate,and it can be used for detection of heavy metals in Chinese crude drugs.

Objective:To investigate the effect of individualized and generalized dual track continuous health education on patients with endometrial cancer after operation.Methods:From January 2019 to January 2020, 96 patients with endometrial cancer in the Second Affiliated Hospital of Henan University of traditional Chinese Medicine were enrolled. They were all treated with surgery. According to the random number table method, they were divided into the control group and the study group, with 48 cases in each group. However, during the whole study period, some patients were affected by various factors, and the final number of patients in the study group was 45 cases (dual track continuous health education combined with individualization and generalization) and 45 cases in the control group(routine continuous health education). Before the intervention and 3 months after the intervention, the obstetrics and Gynecology nurses who had received relevant training adopted self-made health knowledge awareness questionnaire, self-care ability assessment scale (ESCA), Medical Coping Style Questionnaire (MCMQ) and simple quality of life scale (SF-36).The patients' mastery of disease knowledge,self-care ability,coping style and quality of life were evaluated.Results::After the intervention,the awareness of health knowledge was 42.23±2.58 in the study group and 35.71±3.26 in the control group, and the difference was statistically significant ( t value was 4.508, P<0.01). After the intervention, the self-care skills, self responsibility, self-concept, health knowledge level and total score of the study group were 9.45±1.58, 11.82±1.63, 61.12±6.52, 10.56±1.33 and 31.83±2.21 respectively, while those of the control group were 5.34±0.75, 7.85±0.92, 68.23±6.45, 6.35±0.94 and 19.54±1.26 respectively, and the difference between the two groups was statistically significant ( t value was 11.025-16.444, P<0.05). After the intervention, the scores of facing,avoiding and yielding in the study group were 19.39±3.29, 10.58±2.40, 9.20±3.12 respectively, and those in the control group were 15.97±3.77, 14.56±3.00, 13.02±2.50 respectively, with significant difference between the two groups( t value was 4.459, 6.762, 6.220, P<0.01). After the intervention, the scores of physiological function,physical pain,social function,mental health,emotional function,vitality and general health in the study group were 80.23±8.12, 22.19±2.63, 44.98±4.25, 76.25±7.64, 69.58±6.23, 70.05±7.22 and 78.31±7.52 respectively, while those in the control group were 59.63±5.14, 52.37±5.38, 41.16±4.73, 57.28±5.36, 55.25±5.27, 46.89±4.52 and 48.96±4.37 respectively, the difference between the two groups was statistically significant( t value was 3.630-11.870, P<0.05). Conclusions:The implementation of individualized and generalized dual track continuous health education in patients with endometrial cancer after surgery has a significant effect, can significantly improve the patient's mastery of disease health knowledge, enhance their self-care ability and positive coping ability, so as to improve their quality of life, which is worthy of clinical promotion.

Objective To investigate the value of bone marrow imprints in the cytomorphology diagnosis.Methods A total of 354 cases of bone marrow smears,imprints,and sections were analyzed from January 2011 to December 2013 to detect morphological diagnosis difference.Results Bone marrow imprints in groups of extremely reduced,significantly reduced,normal,slightly increased,increased significantly,and extreme increase were better than that of smear which nucleated cells quantity assessment(P ＜ 0.01).Smears and imprints were similar (P ＞0.05).Imprints nucleated cell number decreased mostly were the same as smear,but smear reduced imprints mostly normal or increased.The bone marrow sections nucleated cells quantity as the standard,smears and imprints had high coincidence rate in the group of nucleated cells reduced (87.5％ and 96.9％),and imprints were higher than smear in the group of nucleated cells quantity in normal and increased(87.8％ and 95.7％ vs 68.3％ and 55.8％),and the difference was statistically significant.Imprints were better than smear in specificity,Youden index,and sensitivity.Patients with plasma cell myeloma (PCM) imprint plasma cell volume and immature plasma cells were higher than that of smear (42.73 ± 10.47 and 13.60 ± 4.83 vs 24.67 ± 11.18 and 11.07 ± 5.82) with a statistically significant difference (P ＜ 0.05).Conclusions Imprints have characteristics both smear and sections,and imprints are superior to smears in assessment of nucleated cells and tumor cell invasion degree.Smear combined with imprints can improve the diagnosis level of bone marrow cell cytomorphology.

Purpose:To prove that electroacupuncture pudendal nerve stimulation(EPNS)can exactly excites the pudendal nerve.by simultaneous measurements of pelvic floor muscle (PFM) movements(perineal ultrasound),vaginal pressure and pelvic floor surface myoelectricity.Methods:Long needles(acupuncture needles)were deeply inserted into four sacral points and electrifled to stimulate the Pudendal nerves.When EPNS Was performed.perineal ultrasound B-mode images of PFM movements(contractions),M-mode PFM movement curves;vaginal pressure and pelvic floor surface electromyogram were recorded simultaneously by use of an urodynamic instrument with video suite(Medtronic Duet Encompass).Simultaneous records were also obmined under three conditions in the process of the nerve stimulation:1) pausing electric stimulation;2)reducing the intensity of electric stimulation(to about 2/7 of the original);3)drawing back the two lower needles to make the tips 1-2 cm away from the original position.Results:Thirty-five female patients with stress incontinence(aged 54.9±9.81 received EPNS and the simultaneous measurements.When EPNS was performed correctly,the patient felt rhythmic and cephalad PFM contractions with the urethra as the center.Simultaneous records showed the following:1) cranio-caudal PFM movements on the B.mode image;2)the M-mode curves indicating the PFM contractions (amplitude:about 1 mm,n=31,14 cases≥1 mm and 17 cases＜1 mm);3)A sawtooth curve of changes in vaginal pressure[amplitude:2.61±1.69(0.7-5.6)cmH2O,n=34];4)pelvic floor myoelectric waves[amplitude:23.9±25.3(5-96)μV,n=34].The amplitude of a PFM movement curve conformed basically to that of a vaginal pressure curve.If the electric current was stopped or its intensity was reduced to about 2/7 of the original or during the process of the nerve stimulation the two lower needles were gradually drawn back until the tips were 1-2 cm away from the original positions,then B-mode PFM movements,M-mode curves and sawtooth changes in vaginal pressure disappeared.Conclusion:Electroacupuncture pudendal nerve stimulation can exactly excites the pudendal nerve and effectively contract the pelvic floor muscles.

Objective To observe the effects of Huoxue Chubi Decoction on contents of PDGF-A and TGF-βin skin lesion of scleroderma mimicking mice models;To discuss its possible mechanism. Methods Thirty mice were randomly assigned into blank group, model group, TCM high-, medium-, low-dose group, with six mice in each group. Other than blank group, the rest of the 4 groups were given bleomycin-hydrocholoride 0.1 mL intradermal injection daily for 3 weeks to establish scleroderma mice models. From week 4 to 7, blank group and model group received gavage with equal amount of distilled water daily;TCM high-, medium-, low dosage group received gavage with Huoxue Chubi Decoction with different concentrations of 44.8, 22.4, 11.2 g/kg daily. The pathological changes in the skin tissue samples taken from each group were observed under microscope;the thickness of skin from each group was measured and the expression of PDGF-A, TGF-β, type-Ⅰ collagen (COL-Ⅰ) and type-Ⅲ collagen (COL-Ⅲ) were tested through immunohistochemical staining. Results Compare with blank group, the dermis tissue of model group was thicker, with the presence of thicker and greater number of collagen fibers, as well as infiltration of inflammatory cells. Compare with model group, thickness of skin and dermis collagen growth of TCM high-, medium-, low-dose group were milder varied by the concentration of the decoction. The result of immunohistochemical staining showed that the expressions of PDGF-A, TGF-β, COL-Ⅰ and COL-Ⅲ of modelgroup significantly increased than blank group (P<0.01); the expression of the mentioned indicators were statistically significant lower in the TCM high-, medium-, low-dose group than model group; The expressions of PDGF-A and TGF-β showed a positive correlation with the amount of COL-Ⅰ and COL-Ⅲpresented in each group. Conclusion Huoxue Chubi Decoction can suppress collagen expression and fibroblast formation in skin lesion of scleroderma mice models by down regulating the expressions of TGF-β and PDGF-A, thus demonstrate its potential in scleroderma treatment.

Objective To investigate the expression and the significance of toll-like receptor 3 (TLR-3)in placenta,tumor necrosis factor-α(TNF-α)in maternal and cord blood of idiopathic fetal growth restriction(IFGR),and their correlation with the pathogenesis of symmetric and asymmetric IFGR.Methods From April 2008 to April 2009,42 primiparae of singleton pregnancy and their IFGR babies,who delivered at term through cesarean section, in the Third Affiliated Hospital of Zhengzhou University were enrolled. All subjectects were divided into symmetric IFGR group (n=20) and asymmetric IFGR group (n =22). Another 42 non-IFGR pairs were randomly selected as the control group. The polink-2 plus polymerized horseradish peroxidase (HRP) immunohistochemical method and the enzyme linked immunosorbent assay (ELISA) were applied to detect TLR-3 and TNF-α levels. Results (1) The expression of TLR-3 protein were observed in all maternal placenta of the three groups. TLR-3 essentially expressed in syncytiotrophoblasts and hofbouer cells in the symmetric IFGR and control group, but expressed mostly in hofbouer cells and less in syneytiotrophoblasts in the asymmetric IFGR group. (2) The expression of TLR-3 in the syncytiotrophoblasts of the symmetric and asymmetric IFGR group was significantly lower than in the control group (111±14 and 118±11 vs. 156 ± 9, P<0. 01). The number of TLR-3 positive in Hofbourer cell in the symmetric IFGR group was lower than the control group (8. 9±2. 8 vs 17.5±2. 8, P <0. 01 ), but the number in the asymmetric IFGR group was higher (23.8±3.7) compared with the control group (P <0. 01). (3) The TNF-α levels in the maternal and cord blood of the symmetric and the asymmetric group were higher than that of the control group [maternal : (90±10) μg/L and ( 86±11 ) μg/L vs. (73±9) μg/L;cord blood: (92±12) μg/L and (96±8) μg/L vs. (79±9) μg/L;P<0.01]. (4) Neither symmetric nor the asymmetric IFGR group showed any correlations between the maternal and cord blood levels of TNF-α (P>0. 05). (5) Significant correlation was found between the TNF-α level of the cord blood and TLR-3 expression in the placenta in both the symmetric and asymmetric IFGR group(P<0. 05),but no relationship was found between the maternal blood TNF-α level and TLR-3 expression in the placenta (P>0. 05). Conclusions The variantions of TLR-3 expression in placenta and the increased expression of TNF-α in cord blood are associated with the genesis IFGR. The reduced expression of TLR-3 may related to symmetric IFGR, while the increased TLR-3 level in hofbouer cells may lead to asymmetric IFGR.

BACKGROUND: Fibronectin(FN) plays the role of repair in the inflammation. There is no confirmed conclusion whether it can be applied to the refractory corneal epithelial defect.OBJECTIVE: To observe the repair effect of the human plasma FN for the refractory corneal epithelial defect.DESIGN: A controlled experimental study.SETTING: Guangzhou Red Cross Hospital, Guangzhou First People's Hospital, Guangzhou Children's Hospital, Guangzhou Hospital of Traditional Chinese Medicine and Guangzhou Second People's Hos pital.PARTICIPANTS: Totally 383 eyes with the refractory corneal epithelial defect were chosen, of which 309 were in the therapy group, and 74 in the control group.METHODS: The therapy group: Human plasma FN was administered by dropping it into the eyes once every two hours. The controlgroup: 10 g/L celacol M was administered by its dribbling into the eyes once every two hours. Weilesheng was taken orally in both groups, two pills once, three times per day. According to the state of illness, both groups received anti-bacterial or anti-viral treatment and reexamination was given every day or every other day after administration. 10 g/L fluorescein sodium was used to observe the changes of cornea.MAIN OUTCOSE MEASURES: The symptoms, results of staining using fluorescein sodium as well as the corneal epithelial healing of both groups.RESULTS: The symptoms, the results from staining using the fluorescein sodium and the corneal epithelial healing were used for the evaluation. In the therapy group, 309 eyes were followed up and the cure rate was 69.9%. The average therapeutic period was 6.5 days, while those of the control group were 58.1% and 8.7 days respectively. The difference in the curative effect between the two groups was significantly different( P＜0.01 ).CONCLUSION: The application of FN for the refractory corneal epithelial defect displays a more significant effect than conventional treatment.

Objective: To explore the clinical and laboratory characteristics and therapeutic effect of acute promyelocytic leukemia (APL) with t(2;17;15). Methods: The G-banding technique was used for karyotypic analysis in a female patient with APL who was admitted to the First Affiliated Hospital of Zhengzhou University in December 2018. PML-RARα fusion gene was quickly detected by fluorescence in situ hybridization (FISH). The real-time quantitative polymerase chain reaction (RT-PCR) was used to detection 43 kinds of fusion gene, and the gene mutations were detected by next generation sequencing (NGS). The induction therapy was given with oral retinoic acid+ intravenous infusion of arsenic trioxide, followed by 3 courses of retinoic acid+ arsenic trioxide consolidation therapy. Results: The G-banding karyotypic analysis demonstrated 46, XX, t(2;17;15) (q31;q21;q22)[8]/46, XX[2]. FISH results indicated that 62.0% of analyzed cells were positive for the PML-RARα fusion gene. RT-PCR further revealed the positive PML-RARα fusion gene transcript. NGS detection of gene mutations showed no obvious abnormalities. After 39 days of induction therapy with retinoic acid and arsenic trioxide, the patient achieved complete remission (CR). The karyotype was 46XX[20], and PML-RARα/ABL was 0/100. Then, the patient was treated with 3 courses of consolidation therapy, and the results remained in CR. Conclusions APL with complex t(2;17;15) (q31;q21;q22) is rare, and the morphological characteristics are not typical, but it is still associated with the formation of PML-RARα fusion gene. Retinoic acid+ arsenic trioxide has a good therapeutic effect, and the long-term efficacy still needs follow-up.

Objective:To investigate the effects of Kanglaite injection combined with chemotherapy on quality of life and myelosuppression in patients with non-small cell lung cancer (NSCLC).Methods:The clinical data of 60 patients with NSCLC who received treatment at Zhejiang Jinhua Guangfu Tumor Hospital from August 2018 to February 2022 were retrospectively analyzed. These patients were divided into an experimental group and a control group, with 30 patients in each group according to the treatment methods used. The patients in the experimental group received the Kanglaite injection in combination with chemotherapy using gemcitabine and cisplatin, whereas the patients in the control group were treated solely with chemotherapy with gemcitabine and cisplatin. The quality of life was evaluated using the Karnofsky Performance Status score. Before and after treatment, a comparison was made between the two groups in terms of Karnofsky Performance Status score, the incidence of adverse reactions (such as myelosuppression), and clinical efficacy.Results:After treatment, the disease control rate and objective response rate in the experimental group were 86.67% (26/30) and 60.00% (18/30), respectively, which were significantly higher than 60.00% (18/30) and 30.00% (9/30) in the control group ( χ2 = 4.18, 4.31, both P < 0.05). Prior to treatment, the Karnofsky Performance Status scores in the experimental and control groups were (70.68 ± 3.75) points and (70.29 ± 5.11) points ( t = 0.34, P = 0.790), respectively. After treatment, the Karnofsky Performance Status scores in the experimental group were significantly higher than those in the control group [(67.02 ± 5.87) points vs. (62.37 ± 3.59) points, t = -5.29, P < 0.05]. The incidence of adverse reactions in the experimental group was significantly higher than that in the control group [40.00% (12/30) vs. 36.67% (11/30), χ2 = 0.07, P = 0.790). Additionally, the incidence of myelosuppression in the experimental group was significantly lower than that in the control group [56.67% (17/30) vs. 86.67% (26/30), χ2 = 6.90, P = 0.030]. Conclusion:Compared with chemotherapy alone, Kanglaite injection combined with chemotherapy can effectively relieve the clinical symptoms of patients with advanced non-small cell lung cancer, leading to improved prognosis.

Objective To summarize the nursing cooperation in 28 cases of placenta praevia or dangerous cesarean section delivery in which acute normovolemic hemodilution ( ANH ) in combination with autologous blood transfusion were applied. Methods Before the surgery, autologous blood were collected from 28 cases with smooth anesthesia of ASA classⅠ-Ⅱparturients post general anesthesia, accompanying rapid intravenous infusion of the equivalent colloid solution. The vital sighs and fetal heart of parturients were comprehensive monitored during the collection procedure. When the blood loss reached to 400-600 ml or the hemoglobin ( Hb ) were below 80 g/L during the late phase of surgery, autologous blood was transfused toparturients. Results All 28 cases safely wentthrough the operative period with the mean operation time (69. 00 ±18.81) min, mean blood loss (988.00 ±382.65) ml and mean autologous blood transfusion (387.00 ± 122. 07) ml, respectively. Meanwhile, there were no adverse reactions of parturients during the process of collection and transfusion of autologous blood. Furthermore, the mean 1, 5 min Apgar score of newborn children ranged from 7 to 10. Conclusions ANH in combination with autologous blood transfusion,serving as an effective measure for blood conservation,plays a important role in dealing with postpartum hemorrhage and was not harmful to parturients or fetuses. ANH in combination with autologous blood transfusion, as a safe and efficient blood transfusion mode,attenuated the current shortage of blood for clinical use to a great extent.