ObjectiveExplore the clinical effect of U- 100 double- frequency laser lithotripsy in postoperative residual intrahepatic calculus under choledochoscopy.MethodsSeverty-four patients of postoperative intrahepatic residual stones with U-100 double-frequency laser lithotripsy under choledochoscopy were analyzed retrospectively.ResultsSixty-three (85.1％) of 74 cases were treated successfully in the first operation,8cases ( 10.8％ ) obtained satisfactory outcome in the second operation,and 3 cases (4.1％) in the third.All lithotripsies were performed successfully.ConclusionsU-100 double-frequency laser lithotripsy in postoperative residual intrahepatic calculus under choledochoscopy provides a safe and effective method.

For many years, TCM formula granules, as a new form of decoction pieces reform, have been favored by people with its three features—Three Efficacy, Three Small and Five Conveniences. As a result, it has become the ideal product in the course of TCM internationalization. In the face of growing sales, to formulate its standard becomes imminent. Therefore, how to establish a system that is unique to standardization of TCM formula granules has become a research hotspot of scholars. This article summarized Results of recent research on the preparation, quality control, pharmacology studies and clinical evaluation of TCM formula granules, with a purpose to put forward relevant suggestions, and provide references for standardization of TCM formula granules.

Objective To observe the Influence of Daotan decoction on nonalcoholic steatohepatitis (NASH) in Rats, and its relative mechanisms was analyzed. Methods The rat nonalcoholic steatohepatitis model was induced by high fat diet. The rats of therapeutic groups were treated with small, middle and high dose Daotan decoction respectively. Their general condition, liver index, and the fat change and inflammation of liver were observed. The serum ALT、triglyceride(TG), total cholesterol(TCH), low density lipoprotein(HCL-C), high density lipoprotein(LDL-C)were determined respectively. Results The liver index of therapeutic groups were markedly reduced respectively compared with those of model group(P0.05). The liver inflammation in therapeutic groups were improved better those in model group(P

Objective To evaluate the effect of schistosomiasis control in“Oriental Star shipwreck event”in Jianli County, Hubei Province,so as to provide experiences for schistosomiasis prevention and control in rescue of emergency in the future. Methods According to the data of historical schistosomiasis prevalence and the results of the field survey in the townships in the upstream and downstream of the rescue spots,the emergency handling measures of schistosomiasis control were evaluated. Meanwhile,the Oncomelania hupensis snail situation,priority crowd chemotherapy,key aquatic monitoring,and illness moni?toring of people and livestock were investigated to evaluate the schistosomiasis control effect after the events comprehensively. Results There were no schistosome?infected snails found in the place of shipwreck and the rescue spots. The average density of O. hupensis snails in 5 townships of Jianli County was 0.064 snails/0.1 m2 ,and there were no infected snails found. The positive rate of 2 090 migrants in the schistosomiasis serologic tests was 0.29%and there were no positive ones found in the fecal exami?nation. There were no acute schistosomiasis cases found by the sentinel surveillance fever clinics,and also no positive cattle were found. The results of sentinel mice monitoring in the place of shipwreck and 4 villages in the upstream and downstream showed no infected mice were found. Conclusion The schistosomiasis control measures taken after the shipwreck is effective, which achieves the goal of no schistosomiasis transmission after emergency.

Objective To compare the molluscicidal effects between“Luo-wei”(TDS),a plant molluscicide in 4 percent, and metaldehyde and niclosamide(MNSC)in the field. Methods A natural ecological environment with Oncomelania hupensis was selected as the test area,the test concentrations of TDS and MNSC were 2.5 g/m3 and 2 ml/m3 respectively by the immersion method;the test doses of TDS and MNSC were 3 g/m2 and 2 ml/m2 respectively by the spray method;the doses of WPN in a control group were 2 g/m3 and 2 g/m2 respectively by the two methods above-mentioned. The molluscicidal effects between TDS and MNSC were compared by using the synchronous design method and parallel comparative method. Results In the TDS group,the death rate of snails was 90.70%by immersion for 24 hours,reached to 81.40%after spraying for 7 days,and there were no significant differences among the observation time points in molluscicidal effects(P>0.05). One day after the spraying,the death rate of snails was less in the TDS group compared with that in the MSCN group(P<0.01),but the death rates of snails were similar in both groups 3 days after the spraying(P>0.05). In the MSCN group,the death rate of snails was 99.17%by immersion for 24 hours,reached to 66.07% by spraying for 1 day. In the WPS group,the death rate of snails was 97.15% by immersion for 24 hours,reached to 71.43%after spraying for 1 day,and there were no significant differences(both P>0.05). Conclusion TDS has a good molluscicidal activity and stable efficacy,and the molluscicidal effect of TDS is similar to that of MSCN in the filed, but the molluscicidal sensitivity of TDS is lower than that of MSCN.

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

In China,with the restructuring of health care system moving forward,private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas.However,only limited evidence is available concerning the service functions of private community health facilities in China.The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems.A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs)located in 28 cities of China were investigated in 2008.The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions.The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P＜0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P＞0.05).The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P＜0.05),except for resident health records establishment and health education materials distribution (P＞0.05).At present,the GCHSs are still the mainstream in urban China,which will last for a long period in future.However,our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs,and the PCHSs were willing to provide public health services.In view of current inadequacy of health resources in China,it is feasible to further develop PCHSs under the guidance of the government,given that PCHSs can perform the basic functions of community health services,which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective:To evaluate the safety and efficacy of endovascular interventional treatment of the intracranial vertebrobasilar trunk large aneurysms (VBTLAs) compared with conservative treatment.Methods:This is a prospective multi-center cohort study. From October 2012 to October 2018, a total of 69 patients with intracranial vertebrobasilar trunk large aneurysm (diameter>10 mm) from Henan Province People's Hospital and People's Liberation Army Rocket Medical Center were included in this study. Patients themselves chose either endovascular interventional therapy (interventional group) or conservative treatment (conservative group) after discussion with their doctors. The χ 2 test was used to compare the incidence of deaths, stroke, and all other serious adverse events including other site bleeding, myocardial infarction and others between the two groups. Results:A total of 69 patients were enrolled, of whom 51 patients were enrolled in interventional group, 18 patients underwent endovascular reconstructive therapy, 11 patients underwent deconstructive therapy, and 4 patients underwent conjunction interventional treatments. Eighteen patients were enrolled in conservative group, of whom 11 cases received simple risk factor control, 7 cases received antiplatelet and risk factors control. The proportions of hypertensive patients 94.4% (17/18) and giant aneurysms 50.0% (9/18) in the conservative group were higher than those in the surgery group 64.7% (33/51, χ 2=4.500, P=0.034), 19.6% (10/51, χ 2=4.730, P= 0.030).The incidence of all serious adverse events associated with protocol was 15.7% (8/51) in the interventional group and 44.4% (8/18) in the conservative group [risk ratio (RR) =0.353, 95% confidence intervals (CI): 0.156-0.801], and the difference was significant (χ 2=4.668, P=0.031). The incidence of fatal events associated with protocol was 2.0% (1/51) in the interventional group and 38.9% (7/18) in the conservative group (RR=0.050, 95%CI: 0.007-0.382), and the difference was significant (χ 2=14.281, P<0.001). The incidence of hemorrhage events associated with protocol was 2.0% (1/51) in the interventional group and 22.2% (4/18) in the conservative group (RR=0.088, 95%CI: 0.011-0.738), and the difference was significant (χ 2 =5.391, P=0.020). Follow-up imaging showed that the occlusion rate of aneurysms in 44 patients in the interventional group was 56.8% (25/44) after a median follow-up of 6 months. Imaging follow-up was obtained in 9 patients, whose occlusion rate of aneurysms was 0 and the median follow-up time was 12 months, in the conservative group. The difference was significant(χ 2 =7.534, P=0.006). Conclusion:Compared with conservative treatment, endovascular intervention of the intracranial VBTLAs has lower incidences of serious adverse events and death events.

BACKGROUNDThe prevalence of thyroid nodules (TN) is increasing rapidly. This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules (MN) to provide more understanding of the differential diagnosis of TN.

METHODSA total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study. The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN. The nature of TN (benign nodules (BN) or MN), medical records, laboratory data, and imaging data were analyzed. The risk factors for MN were screened using Spearman's rank correlation analysis and nonconditional binary Logistic regression analysis.

RESULTSThe number of surgically treated TN cases increased yearly. A total of 34.33% of cases were MN and 65.67% were BN. Up to 56.74% of these cases underwent unnecessary surgery. Among the MN cases, papillary thyroid carcinoma accounted for 94%, in which 46.71% coexisted with benign thyroid disease and 32.28% with multiple foci. Single-related factor analysis showed that age, employment, disease duration, history of breast nodules and/or hypertension, the levels of serum thyroid-stimulating hormone (TSH), thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPoAb), and ultrasound features of TN were related to MN. Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN, including <40 years old, previous history of breast nodules and/or hypertension, disease duration <1 month, employment, hypoechoic nodule, irregular nodules, nodule calcification, solid echo nodule, fuzzy boundary, rich blood flow within nodules, abnormal lymph nodes around the neck, nodule diameter <1 cm, and abnormally high TgAb.

CONCLUSIONSOur results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary surgeries in some cases. This study also suggest that age, duration of thyroid disease, history of breast disease and/or hypertension, the levels of serum TSH, TgAb, and TPoAb, and ultrasound features of TN are related to MN, and some of these factors may be the risk factors for MN.

Adult ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; epidemiology ; Thyroid Nodule ; epidemiology