Objective: To establish a method for the determination of curcumine and berberine hydrochloride in Shangke Dieda paste. Methods:An HPLC method was adopted to determine the content of curcumine and berberine hydrochloride in Shangke Dieda paste. For curcumine, the column was InertSutain C18 (250 mm × 4. 6 mm,5 μm); the mobile phase was acetonitrile and 4% acetic acid solution (44 ∶56);the flow rate was 1. 0 ml·min-1;the column temperature was 25℃;the detection wavelength was 430 nm;the sample size was 10μl. For berberine hydrochloride, the column was InertSutain C18 (250 mm × 4. 6 mm,5μm);the mobile phase consisted of acetonitrile-0. 1% phosphoric acid (44 ∶56, 0. 2 g dodecyl sodium sulfate was added to 100 ml solution); the flow rate was 1. 0 ml·min-1;the column temperature was 25℃ ;the detection wavelength was 345 nm;the sample size was 10 μl. Results:A good linear correlation was obtained within the range of 0.01-0.50 μg (r =0.999 3) for curcumin and 0.02-0.16 μg(r =0. 999 9) for berberine hydrochloride. The average recovery was 101. 03% with RSD of 1. 75% for curcumin and 99. 20% with RSD of 0. 64% for berberine hydrochloride (n=9). Conclusion:The established method is simple, accurate, sensitive and specific, which can be used for the quality control of Shangke Dieda paste.

Objective To investigate the morphological characteristics and proliferation ability of diabetes mellitus-derived adipose-derived stem cells (ADSCs) by comparing with normal-derived ADSCs.Methods The ADSCs could be achieved from diabetes mellitus' adipose tissue by the similar method of normal ADSCs isolation and culture,and then the differnce was compared between the two groups about their morphologies under microscope,and the proliferation ability of two groups was determined by CCK-8.Results ADSCs in patients with diabetes were obvious hypertrophy and irregular in morphology.A values of ADSCs in diabetes and non-diabetes were 0.210+0.002 and 0.390+0.006 in 1st day;0.250+0.015 and 0.443+0.023 in 2nd day;0.368+0.014 and 0.726+0.033 in 3rd day;0.368+0.014 and 0.726+0.033 in 4th day;1.767+0.072 and 3.153+0.067 in 5th day and 1.810+0.072and 3.170+0.021 in 6th day,respectively.The difference was statstically significant at the beginning from 4th day (P＜0.05).Conclusions There is obvious difference of the microscopic morphology between the diabetes mellitus-derived ADSCs and normal-derived ADSCs.The proliferation ability of the diabetes mellitus-derived ADSCs is lower than normal-derived ADSCs.These difference could be closely related to ulcerous non-healing wounds in patients with diabetes mellitus.

Objective To provide anatomical basis for the thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators. Methods ① The course and distribution of thigh medial cutaneous nerve. ②Anastomosis between descending genicular artery perforators and thigh medial neurocutaneous vascular, were observed on 40 specimens of adult lower limb perfused with red latex. Mimic operation was performed on one side of fresh specimen. Results ①The line between the midpoint of inguinal ligament and medial femoral condyle can be considered as the projection on body surface of thigh medial cutaneous nerve. ②Perforating branches of descending genicular artery (infrapatellar branch )started from the lower edge of medial femoral condyle about 4 cm, and passed through the deep fascia in which the triangle depression surrounded by the vastus medialis muscle, adductor tendon and the medial femoral condyle to the subcutaneous. They also separated large number of small blood vessels, which closely aligned with the perineural and neural stem vascular chain of thigh medial cutaneous nerve. Then they formated vascular plexus in the upper part of thigh along the thigh medial cutaneous nerve longitudinal axis. Conclusion The thigh medial neurocutaneous vascular flap pedicled with descending genicular artery perforators can be formed to repair soft tissue defect around knee joint.

Colorectal Cancer (CRC) is a kind of molecular diversified neoplasm.For nonmetastatic early CRC patients who received surgery based systemic treatment,the 5 years survival rate is as high as 50％-80％.However,only chemotherapy is available for majority of metastatic advanced CRC patients.The effect of chemotherapy is disappointing.Numerous studies have demonstrated that some patients with metastatic advanced CRC can benefit from anti-EGFR and anti-VEGF monoclonal antibodies.Here,we give a brief overview about the clinical research of the detection of KRAS,BRAF,MSI and HER2in guiding treatment with targeted drugs in metastatic advanced CRC

ObjectiveTo realize the relevance between hypertension and serum uric acid (SUA) in residents in Baise City.MethodsTwenty one thousand,five hundred and eighty eight Baise residents were examined.The body weight,height,waist circumference,hip circumference,blood pressure(BP) were recorded and blood lipidlevels,blood glucoseand serum uric acid (SUA) were tested.The relevance between hypertension and hyperuricemia (HUA) was analyzed by multi-factor variance analysis,x2 test,t test,linear regression and Logistic regression analysis.ResultsHypertension prevalence rate was 31.5％,the frequency of HUA was 12.0％,and 5.8％ residents had both.For patients with both hypertension and HUA,when compared to those with normal serum uric level,their mean diastolic blood pressure(DBP) was(84±10),(72±6) mm Hg res-pectively,there mean systolic blood pressure (SBP) was(151±12),(127±6) mm Hg respectively,and pulse pressure (PP) was (50±12),(37±8) mm Hg respectively.The average BMI of those two groups was (23.9±2.6),(21.7±2.4) kg/m2 respectively.The average TC level was (6.0±1.3),(5.2±1.1)mmol/L respectively,the average TG level was(2.3±2.2),(1.5±0.7) mmol/L respectively,and the average LDL-C level was(3.4±1.3),(3.0±1.1) mmol/L respectively.All these parameters were higher than those people without hypertension or HUA(P＜0.01).However,the situation of HDL-C[ (1.2±0.4),(1.5±0.5)mmol/L] was the opposite (P＜0.01).Regression analysis had shown that age,BMI,waist-hip ratio,SUA,blood glucose,TC,TG,HDL-C and LDL-C were independent risk factors for hypertension,while people with HUA was 3.1 times more when compared to those without HUA.The prevalence rate of HUA in people with hypertension was 2.6 times higher than that of the control group.ConclusionHypertension and HUA are two public health problems that prevalent in the residents in Baise City.Obesity,high blood glucose level and hyperlipidemia are thebasis for the development of hypertension and HUA.Hypertension can be the cause of HUA and verse versa.They may have mutual interactions.The adverse effect of HUA on-cardiovascular system should be taken into consideration clinically.

Objective To investigate the causes of disease condition changes after the patients' transfer from intensive care unit (ICU) into the general wards. Methods From January 2013 to December 2018, the patients with improvement of disease condition in comprehensive ICU were transferred into the general wards of the First People's Hospital of Lianyungang and their clinical data were retrospectively analyzed. The general information of patients was collected, such as gender, age, underlying diseases, heavy smoking, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and Glasgow coma score (GCS) in 24 hours, length of stay in ICU, average levels of oxygenation index and respiratory rates during the stay in ICU and on the day transfer from ICU, GCS score on the day of transfer from ICU, presence or absence of invasive ventilation,the time of invasive ventilation, sepsis or its absence, the situation of community or hospital acquired pneumonia, etc, and the classification of the disease changes after transfer. The patients were divided into a disease situation change group (change group) and a disease situation stable group (stable group) according to whether there was any change in the disease situation in the general ward or not, the patients were divided into respiratory complications group and non-respiratory complications group. The risk factors that may influence the change of the disease condition were analyzed by multiple-factor Logistic regression. Results From January 2013 to December 2018, there were 2 451 patients treated in comprehensive ICU, of that 1 293 were transferred into the general wards for further treatment. Among the patients transferred to the general ward, 628 cases' conditions were changed.① The respiratory complications were the most common changes (345 cases, 54.9%) in patients after the transfer from ICU, followed by cardiovascular complications (118 cases, 18.8%) and surgery-related complications (96 cases, 15.3%).② The proportions of underlying diseases and heavy smoking in the change group were significantly higher than those in the stable group [24.4% (153/628) vs. 7.8% (52/665), 40.3% (253/628) vs. 24.2% (161/665), all P < 0.05]. Compared with the stable group, the average oxygenation index [mmHg (1 mmHg = 0.133 kPa): 238.91±71.14 vs. 291.74±63.64], and the turn-out day oxygenation index (mmHg: 261.23±58.11 vs. 301.00 ±58.25) were lower in the change group, while the proportion of applying invasive ventilation [64.2% (403/628) vs. 47.4% (315/665)], and the duration of invasive ventilation [days: 5 (2-9) vs. 3 (2-7)] were higher in the change group, the differences being all statistical significant (all P < 0.05). ③ Compared with the non-respiratory complications group, the average oxygenation index in the respiratory complications group was lower (mmHg: 216.43±67.17 vs. 264.85±78.46), the turn-out day oxygenation index was lower (mmHg: 250.72±74.93 vs. 274.87±81.79), and invasive ventilation ratio was higher [77.4% (267/345) vs. 48.1% (136/283)], the differences being statistically significant (all P < 0.05).④ Logistic regression analysis showed that the underlying diseases [odds ratio (OR) = 1.522], heavy smoking (OR = 2.314), and average oxygenation index (OR = 1.821) were the independent risk factors for patients in the general wards occurring disease situation changes after transfer from ICU (all P < 0.05). Conclusions The patients with following factors: underlying diseases, heavy smoking, low average oxygenation index during ICU stay, low oxygenation level on the day of transfer, application of invasive ventilation and long ventilation time are more easily to occur complications of respiratory system in the general wards after transfer from ICU; among the above related factors, the underlying diseases, heavy smoking and average oxygenation index are the independent risk factors for patients' occurrence of disease situation changes after transfer from ICU. Therefore, the patients with these risk factors, the evaluation and monitoring of the disease situation should be strengthened before and after patients' transfer from ICU. and the changes of patients' condition are mostly respiratory complications. Among them, combined underlying diseases, severe smoking and average oxygenation index are the independent risk factors for patients who have condition changes transferred from ICU. For patients with these risk factors, evaluation and monitoring should be strengthened before and after patients are transferred from ICU.

Due to the problems of language barriers and cultural differences existing in the current clinical practice teaching activities of overseas students, this study proposes to divide the oversea students and Chinese students into bilingual mixed groups in the ward rounds teaching. Through the selection of typical cases and the application of flipped classroom, the Chinese and English versions of learning materials related to disease are provided to the interns for learning in advance, and the oversea students and Chinese students are requested to complete the history and auxiliary examination data collection in Chinese and English in cooperation, and then the teacher leads the group to carry out ward rounds teaching, including bedside English history report, physical examination, case analysis, discussion and summary, so as to improve the participation enthusiasm of overseas students and also improve the teaching effects.

"Good doctor" plus "good patient" do not necessarily mean "good doctor-patient relationship", but both are the basis for building a harmonious doctor -patient relationship and neither of the two can be dis-pensed. This paper conducted a comparative study on ideal and realistic doctor-patient relationship, digged and refined the characteristics of"good doctor" and"good patients", and agreed that it was possible to construct a har-monious doctor-patient relationship when doctors pursued professional excellence and moral integrity, and patients had good "patient literacy".

Objective:To compared the positive rate of anal swab nucleic acid test and clinical characteristics of critical and general coronavirus disease 2019 (COVID-19) patients.Methods:Clinical data of 18 patients with COVID-19 admitted to the First People's Hospital of Lianyungang City from February to March 2020 were retrospectively analyzed. The patients were divided into general group ( n = 11) and critical ill group ( n = 7) according to the severity of the disease. The differences of gender, age, epidemiological characteristics, fever duration after admission, underlaying disease, positive rate of anal swab nucleic acid test at admission and two times of negative pharyngeal swab test were compared between the two groups. Results:There were no significant differences in gender, age, fever duration after admission or underlaying disease between the two groups. The number of anorectal swab positive cases in critically ill group was significantly higher than that in general group (cases: 4 vs. 1, P = 0.047). After two negative pharyngeal swab nucleic acid test, the number of anal swab positive cases in critical illness group was still higher than that in general group (cases: 2 vs. 0), but the difference was not statistically significant ( P = 0.137). The number of non-local infection in critical ill group was significantly higher than that in general group (cases: 4 vs. 0, P = 0.047). All of the 4 non-local infected patients had a history of living in Wuhan. Conclusions:The patients with anorectal swab nucleic acid positive may have a more serious condition. It may be a risk to transfer ill patients out of the isolation ward by the criteria of only two times of negative pharyngeal swab nucleic acid test. Patients returning to our city after infection in Wuhan may be more serious.

BACKGROUND:It has also been confirmed that ferroptosis is closely related to a variety of musculoskeletal diseases,such as rheumatoid arthritis,osteosarcoma,and osteoporosis.The pathophysiological mechanisms of ferroptosis and osteoporosis need to be further studied and elucidated to broaden our understanding of iron metabolism and osteoporosis.It will provide research ideas for the future elucidation of new mechanisms of osteoporosis and the development of new technologies and drugs for the treatment of osteoporosis. OBJECTIVE:To provide an overview of the current status of research on ferroptosis in osteoporosis,to provide a new direction for future research on the specific molecular mechanisms of osteoporosis,and to provide more effective and better options for osteoporosis treatment strategies. METHODS:The first author used the computer to search the literature published from 2000 to 2024 in CNKI,WanFang,VIP,and PubMed databases with search terms"ferroptosis,iron metabolism,osteoporosis,osteoblast,osteoclast,bone metabolism,signal pathway,musculoskeletal,review"in Chinese and English.A total of 68 articles were finally included according to the selection criteria. RESULTS AND CONCLUSION:(1)Ferroptosis is a new type of cell death discovered in recent years,which is usually accompanied by a large amount of iron accumulation and lipid peroxidation during cell death,and its occurrence is iron-dependent.This is distinctly different from several types of cell death that are currently being hotly studied(e.g.,cellular pyroptosis,necrotic apoptosis,cuproptosis,and autophagy).(2)Intracellular iron homeostasis is manifested as a balance between iron uptake,export,utilization,and storage.The body's iron regulatory system includes systemic and intracellular regulation.The main factor of systemic regulation is hepcidin produced by hepatic secretion,and cellular regulation depends on the iron regulatory protein/iron response element system.Of course,intracellular iron homeostasis can be controlled by other factors,such as hypoxia,cytokines,and hormones.(3)Lipid peroxidation causes oxidative damage to biological membranes(plasma membrane and internal organelle membranes),lipoproteins,and other lipid-containing molecules.Polyunsaturated fatty acid-containing phospholipids are important targets of lipid peroxidation.Free polyunsaturated fatty acid is an important substrate for lipid oxidation and can bind to the phospholipid bilayer,leading to over-oxidation and thus triggering lipid apoptosis.(4)Several studies have shown that osteoblasts are overloaded with iron in different ways,resulting in the accumulation of unstable ferrous iron and the generation of reactive oxygen species and lipid peroxides,causing ferroptosis of osteoblasts and ultimately a decrease in bone formation,affecting bone homeostasis and the development of osteoporosis.(5)Osteoclasts are large multinucleated cells formed by the fusion of mononuclear macrophage cell lines or bone marrow mesenchymal stem cells induced by nuclear factor-κB ligand receptor activator,and they have the function of bone resorption.Iron ions can promote osteoclast differentiation and bone resorption through the production of intracellular lipid reactive oxygen species,while iron chelators can inhibit osteoclast formation in vitro and thus affect the occurrence and development of osteoporosis.