Objective To explore the efficacy of coblation nucleoplasty for the treatment of lumber disc herniation.Methods A total of 40 patients with lumber disc herniation were treated with coblation nucleoplasty in our hospital.Discogram was taken before the surgery.The patients with negative results were excluded from this series.Results The operation was completed in all the 40 cases(44 interspinous spaces).They were followed up for 2 to 8 months(mean 5 months).According to the Nakano's criteria,the outcome of the surgery was excellent in 8 and good in 29,accounting for 92%(37/40)of the patients.In the patients with central type lumber disc herniation,8(80%,8/10)had excellent or good outcome;whereas,in those with lateral type herniation,97%(29)of the 30 patients had such results.None of this series had complications.Conclusion Coblation nucleoplasty is a simple,safe,and effective surgery with minimal invasion for lumber disc herniation.

Objective To discuss the surgical characteristics,safety and perioperative management of carotid stent angioplasty (CSA) for the treatment of severe carotid artery stenosis (＞85％).Methods From December 2011 to May 2016,a total of 25 patients with carotid artery stenosis (＞85％) were treated with CSA.According to the stenotic characteristics of the lesion,distal cerebral protection device was employed in performing CSA.During the operation,attention was paid to individualized and detailed surgical management and perioperative management program;the revascularization and the dropping-off of thrombus in cerebral protection device were under close observation,while effort was made to control the occurrence of complications.The patients were followed up for one year to observe the occurrence of ischemic cerebrovascular events.Results The cerebral protection device was successfully deployed after it passed over the severe carotid artery stenosis.After balloon pre-dilation the stent was deployed,and the stent showed satisfactory shape.North America Symptomatic Carotid Endarterectomy Testing (NASCET) showed that the average degree of carotid artery stenosis was decreased from preoperative (91.0±3.1)％ to postoperative (21.0±5.1)％.The protective umbrella was successfully retrieved in all patients,and deciduous tissue fragments were observed in 6 retrieved protective umbrellas.During the perioperative period no severe complications,such as cerebral hemorrhage,cerebral infarction,hyper-perfusion syndrome or death,were observed.All the 25 patients were followed up for one year,and no transient ischemic attack,stroke or death occurred.Conclusion In treating severe carotid artery stenosis with CSA,in order to ensure a successful surgery and patient's safety the following points are very important:in-operative individualized and detailed management,perioperative preventive measures,and use of appropriate cerebral protection device.

OBJECTIVE:To establish UPLC fingerprint of Gehua formula granules. METHODS:UPLC method were adopted. The determination was performed on Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water at the flow rate of 0.5 mL/min. The detection wavelength was set at 264 nm,column temperature was 25 ℃,and the sample size was 1 μL. Using tectorigenin as reference substance,UPLC chromatograms of 10 batches of Gehua formula granules were determined. The common peak identification and similarity evaluation were conducted by TCM Chromatogram Fingerprint Similarity Evaluation Sys-tem(2004 A edition). RESULTS:14 common peaks were identified in UPLC chromatograms of 10 batches of Gehua formula gran-ules and similarities were all higher than 0.90. UPLC chromatograms of 10 batches of samples were in good agreement with control fingerprint. CONCLUSIONS:Established UPLC fingerprint can provide reference for identification and quality evaluation of Gehua formula granules.

Objective To study influences of intervention in pregnant women with positive thyroid autoantibodies on the thyroid function of babies. Methods A total of 55 pregnant women were enrolled with positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) during prenatal checkup. They were randomly divided into two groups: intervening group( n= 36, newborn group A) was treated with levothyroxine ( L-T4 ), and non-intervening group ( n= 19, newborn group B) was not treated. 30 cases of pregnant women with negative thyroid autoantibodies served as a normal population control group (newborn group N). Serum TSH, TPOAb, TgAb, TT3, TT4, FT3 and FT4 were measured by high-sensitive immunochemiluminescent assay ,and urinary iodine was also examined in the pregnant women. Fetal plasma TSH, TT3, TT4, FT3, and FT4 levels were measured after cutting the umbilical cord from placenta, and repeated measurements were made by 3-4 weeks and 8-10 weeks postpartum. Results At baseline, serum TSH levels of the pregnant women in intervening and nonintervening groups were significantly higher than that in control group ( P＜0.05 ). Non-intervening group had higher TSH and lower TT3, TT4, FT4 compared with the other two groups (P＜0. 05 or P＜0.01 ). The cord blood TSH levels of the neonates in both group B [(7.06 ± 1.31 ) mIU/L] and group A [(6.23 ± 1.26 ) mIU/L] were significantly higher than that of group N [(5.48±1. 17) mIU/L, P＜0.01 and 0. 05]. By 3-4 weeks postpartum,the serum TSH level [(3.21±0.70)mIU/L] in group B was significantly higher than those in group N [(2.72±0.51)mIU/L] and group A [(2.78±0.42) mIU/L, all P＜0.05]. The serum TSH level in group B [(2.99±0.57) mIU/L] was still higher than those in group N [(2.48±0.68) mIU/L] by 8 to 10 weeks postpartum (P＜0.05 ). Multiple stepwise regression analysis revealed that TSH, TPOAb, and urine iodine levels of mothers were independently related to TSH of their infants. Conclusion When differences in thyroid function exist in pregnant women, these differences also reside in their offspring. The thyroid function in neonates correlates with both the thyroid autoantibodies and thyroid function of their mothers.

Objective To explore the effect of risk assessment tracking management in reducing unplanned extubation in patients with tracheal intubation.Methods From January to December 2015,120 patients with tracheal intubation in ICU were selected as the control group with routine nursing care of indwelling endotracheal intubation.From January to November 2016,120 patients with tracheal intubation were selected as the observation group,where the risk assessment and risk management were done on the basis of routine nursing as in the control group.The two groups were compared in terms of tracheal intubation and unplanned extubation related knowledge,the implementation of the risk assessment,the accuracy in risk assessment and the incidence of unplanned extubation.Result The tracheal intubation and unplanned extubation related knowledge in the observation group was lower than that of the control group (P＜0.001),The implementation rate of the risk assessment and the accuracy in risk assessment in the observation group were significantly higher than the control group,and the rate of unplanned extubation in the observation group was significantly lower than in the control group (all P＜0.01).Conclusion The implementation on risk assessment and extubation-preventing nursing quality tracing management can enhance the awareness and knowledge of preventing trachea cannula exodus,improve the quality of nursing and reduce the rate of unplanned extubation.

AIM To establish the HPLC fingerprints of Cajanus cajan (L.) Millsp.leaves and to determine the contents of orientoside and luteolin.METHODS The analysis of 65％ methanol extract from C.cajan leaves was performed on a 25 ℃ thermostatic Agilent Zorbax SB-C18 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of methanol-1％ acetic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 260 nm.RESULTS There were twenty-one common peaks in ten batches of samples (S1-S10),whose similarities were more than 0.950,except for that of S3 (0.516).Orientoside and luteolin showed good linear relationships within the ranges of 0.089 5-3.960 μg and 0.015 5-0.408 μg,whose average recoveries were 99.43％ (RSD =1.32％) and 98.50％ (RSD =0.82％),respectively.The contents of two constituents in the samples from three growing areas (Guangdong,Yunnan and Hainan) showed obvious differences.CONCLUSION This simple,accurate and reproducible method can be used for the quality control of C.cajan leaves.

Objective To evaluate the safety and effective of ultrasound-guide percutaneous radio frequency ablation (RFA).Methods Retrospectively analyze the incident,management and influence factors of complication of ultrasound-guide percutaneous RFA.Results From 2001 to 2011,536 patients with 762 lesions underwent RFA were enrolled in this study.Incident of RFA complication was 2.03％ (11/536),including 5 (0.92％) major complication.The complication covered fever (1 case),massive hydrothorax (2 cases),hydrothorax accompany with ascites (1 case),massive ascites (1 case),liver abscess (1 case),liver capsule hemorrhage (1 case) and hemothrorax (1 case).No RFA relate mortality was observed.According to logistics regression analysis,the liver function Child-Pugh grading was associated with the RFA complication (P =0.005).Conclusions Ultrasound-guide percutaneous RFA is a safe and effective local treatment approach for hepatocellular carcinoma.It's necessary to comprehensively think over the basic condition of patients and the characters of tumor such as tumor location,size and abutting organs.Nevertheless,an appropriate treatment plan and closely monitor during and after RFA are crucial.

Objective:To conduct scoping review of researches on application of traditional Chinese medicine exercises in exercise rehabilitation of patients with heart failure, so as to provide reference for effective clinical intervention of traditional Chinese medicine exercises.Methods:Chinese and English literature published in PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, Wanfang Database and China Biology Medicine disc were searched by computer, and the search deadline was from database establishment to May 28, 2023. The Joanna Briggs Institute Scoping Review Guide was used as a methodological framework to summarize and analyze the included literature.Results:A total of 19 literatures were included, including 17 randomized controlled trials and 2 quasi-randomized controlled trials. The subjects of the intervention were heart failure patients with New York Heart Association heart function gradeⅠ toⅢ. The types of exercises mainly included Eight Pieces of Brocade and Tai Chi. The intervention duration was mostly 30 min each time, and the frequency was mostly 3 to 5 times a week. The intervention intensity was mostly based on The Borg Rating of Perceived Exertion (RPE), and the intervention duration was mostly 3 months. Most of the implementation scenarios were "hospital-home" or home. Traditional Chinese medicine exercises had a positive effect on the clinical symptoms, psychological state and quality of life of patients with heart failure, and were safe and feasible.Conclusions:Traditional Chinese medicine exercises have a positive effect on the exercise rehabilitation of patients with heart failure, and are safe and feasible.

Objective To deeply analyze the problems of public hospitals in medical service satisfaction,construct a more applicable and explanatory service satisfaction evaluation model,and provide reference for the improvement path of patients'medical service satisfaction.Methods Based on the ESCI model,this paper puts forward a research hypothesis,compiles the"Medical Service Satisfaction Evaluation Scale of Public Hospitals in S City",selects S public hospitals as the research object,and evaluates medical service satisfaction from the perspective of patients.Results At present,the main problems affecting the improvement of patients'satisfaction with medical service management in public hospitals in S city are as follows:it is urgent to improve the diagnosis and treatment technology in terms of hardware quality and optimize the environmental hygiene of public hos-pitals,and it is an urgent task to shorten the waiting time for medical treatment in software quality.The score of medical service satisfaction evaluation of S public hospitals was 3.76,and the satisfaction of patients in S public hospitals with their medical serv-ices was at a moderately low level.Conclusion In view of the above problems,it is recommended to strengthen the construction of key specialties,strengthen the construction of talent team,optimize the medical process,open digital linkage services,and strengthen service management,so as to promote the improvement of patients'satisfaction with medical services.

Crawling is a significant sign of gross motor development in infants,and also an important means of rehabilitation training for patients with motor disorders.The accurate measurement of the motion state during human crawling is essential for evaluating the gross motor developmental process in infants and the rehabilitation outcome of patients with motor disorders.In recent years,many studies have attempted to quantitatively evaluate the motion state by detecting physiological signals during human crawling,but there is a lack of overview on human crawling motion signal acquisition and processing.Herein the detection and processing methods for motion signals during human crawling and relevant researches are reviewed.The mainstream methods for detecting motion signals during human crawling are introduced from the perspectives of inertial sensors,pressure sensors,and surface electromyography.Then,the signal processing and analysis such as periodic segmentation,kinematic analysis,and dynamic analysis in human crawling are summarized.Based on the theory of motion coordination,the research advances in joint synergy and muscle synergy during human crawling are elaborated.Finally,the current problems and future development directions of motion analysis for human crawling are discussed.