AIM: To establish the method for quality control of Chansu Tongbi Ointment(Venenum Bufonis,Borneolum Syntheticum,Radix Stephanial Tetrandrae etc.) METHODS: Radix Stephaniae Tetrandrae in Chansu Tongbi Ointment was identified by TLC,and the content of cinobufagin and resibufogenin were determined by HPLC. RESULTS: Radix Stephaniae Tetrandrae could be identified by TLC.Cinobufagin showed a good linear relationship at the range of 1.15 ?g-5.75 ?g,r=0.999 7.The RSD of measurement precision test was 1.05%,The average recovery was 97.95%(RSD=1.63%,n=5).Resibufogenin showed a good linear relationship at the range of 1.05 ?g-5.25 ?g,r=0.999 6.The RSD of measurement precision test was 1.02%,The average recovery was 97.45%(RSD=0.61%,n=5. CONCLUSION: The method is accurate,reliable and available with a reproducibility and can be used to control the quality of this ointment effectively.

Objective To investigate effects of mental nursing on psychological state of patients with pneumoconiosis. Methods 160 pneumoconiosis patients were divided into 8 groups randomly,and 20 patients were included in each group. Psychological characteristics were observed before mental nurs-ing, and 15, 30 and 60 days after mental nursing. The numbers of the youth, the middle-aged and the el-derly patients who demonsrated four or more kinds of psychological characteristics after 60 days mental nursing were compared.320 patients of the same kind were divided into the two aspects of mental nursing group and all aspects of mental nursing group, the number of patients who appeared four or more kinds of psychological characteristics after 60 days mental nursing was recorded. Results The number of pneu-moconiosis patients who clearly appeared four or more kinds of psychological characteristics decreased after 15 days, but it had no statistical significance, the number decreased significantly after 30 days and 60 days of mental nursing, and the latter decreased more significantly.Both of the numbers of two aspects of mental nursing group and all aspects of mental nursing group decreased significantly, and the latter decreased more significantly.The number of the youth decreased most significantly, while it had no statistical significance between the middle-aged and the elderly group. Conclusions Mental nursing for the pneumoconiosis pa-tients is a long-term project, comprehensive mental nursing to pneumoconiosis patients has great influence, but the influence varies for patients with different ages.

Objective:To investigate the clinical efficacy of Yunkang oral liquid combined with dexamethasone and low-molecular-weight heparin in the treatment of recurrent spontaneous abortion (RSA) complicated with pre thrombotic state (PTS), and its effects on thromboelastogram and serum progesterone, β-human chorionic gonadotropin (β- hCG), and helper T cell (Th) 1/Th2 cytokine levels in patients with recurrent spontaneous abortion (RSA).Methods:A prospective selection of 94 RSA patients with PTS admitted to the Baoding Second Central Hospital from January 2015 to December 2020 was conducted. They were randomly divided into two groups using a random number table method, with 47 patients in each group. The control group was treated with dexamethasone combined with low molecular weight heparin, while the observation group was treated with Yunkang oral liquid in addition to the control group. Continuously treat until 12 weeks of pregnancy to evaluate the efficacy of both groups and observe the adverse reactions in both groups. Two sets of thromboelastogram parameters were compared before and after treatment, including clot formation time (K value), clot reaction time (R value), and clot formation rate (α angle), maximum clot strength (MA value), and coagulation comprehensive index (CI), as well as serum progesterone β- hCG, Th1/Th2 cytokine levels. The pregnancy outcomes of the two groups were followed up.Results:The total effective rate of the observation group [95.7%(45/47)] was significantly higher than that of the control group [83.0%(39/47), P<0.05]. After treatment, the K and R values of both groups were significantly prolonged compared to before treatment (all P<0.05), the angle α, MA value, and CI value were significantly reduced compared to those before treatment (all P<0.05); After treatment, the K and R values in the observation group were significantly longer than those in the control group (al P<0.05), The angleα, MA value, and CI value were significantly lower than those of the control group (all P<0.05). After treatment, the levels of β- hCG serum progesterone of the two groups were significantly higher than those before treatment (all P<0.05), and The β-hCG levels of the serum progesterone were all higher than those in the control group (all P<0.05). After treatment, The levels serum Th1 cytokines [interferon-γ (INF- γ), tumor necrosis factor- α (TNF- α)] of both groups were significantly decreased compared to those before treatment (all P<0.05), and the levels of serum Th2 cytokines [interleukin-4, IL-10] were significantly increased compared to those before treatment (all P<0.05); After treatment, the observation group's serum IFN- γ, TNF- α were significantly lower than those of the control group (all P<0.05), and The levels of serum IL-4 and IL-10 were significantly higher than those of the control group all P<0.05). The live birth rate of the observation group was 87.2%(41/47), which was higher than that of the control group [70.2%(33/47)] ( P<0.05). There was no statistically significant difference in the adverse reaction rate between the observation group [6.4%(3/47)] and the control group [4.3%(2/47)] ( P>0.05). Conclusions:The treatment of RSA combined with PTS with Yunkang oral liquid, dexmedroxyprogesterone, and low molecular weight heparin can significantly alleviate blood hypercoagulability, increase reproductive endocrine hormone levels, regulate Th1/Th2 cytokine balance, improve live birth rate and clinical efficacy, and is safe and reliable.

Objective To screen and identify the in vivo-induced antigen Tp0462 of Treponema pallidum (Tp),and to evaluate its value for clinical serological diagnosis of syphilis.Methods Genomewide DNA was extracted from the Tp Nichols strain,and polymerase chain reaction (PCR) was performed to amplify the Tp0462 gene.A recombinant plasmid pET30a (+)-Tp0462 was constructed and transfected into the Escherichia coli (E.coli) Rosetta (DE3) strain.Recombinant protein Tp0462 was abundantly expressed,purified and identified.A total of 18 New Zealand rabbits were randomly and equally divided into 3 groups:viable Tp-incubating group incubated with viable Tp in the testes,inactived Tp-incubating group incubated with ultraviolet irradiation-killed Tp in the testes,and control group receiving no treatment.After incubation,blood samples were collected at different time points,and the sera were isolated for identification of characteristics of in vivo-induced antigen Tp0462.Enzyme-linked immunosorbent assay for Tp0462 (Tp0462-ELISA),Treponema pallidum particle agglutination assay (TPPA),preliminary syphilis screening ELISA and rapid plasma reagin (RPR) card test were applied in 336 clinical serum samples from patients with syphilis,so as to preliminarily evaluate the value of Tp0462 for the diagnosis of syphilis.Results The optimum conditions for expression of the recombinant plasmid Tp0462-pET30a(+) in E.coli Rosetta (DE3) strains were the treatment with 0.5 mmol/L isopropyl thiogalactoside (IPTG) on a shaker at 180 rpm for 4 hours.In the viable Tp-incubating group,the serum level of specific anti-Tp0462 antibody sharply increased from week 2,and went steady after week 5.However,the specific anti-Tp0462 antibody maintained a low level in the inactived Tp-incubating group and the control group.The viable Tp-incubating group showed a significantly higher level of specific anti-Tp0462 antibody compared with the inactived Tp-incubating group and the control group (both P ＜ 0.05),while no significant difference was observed between the inactived Tp-incubating group and the control group (P =0.256).The level of anti-Tp92 antibody was significantly higher in the viable Tp-incubating group and the inactived Tp-incubating group than in the control group (P ＜ 0.05),while there was no significant difference between the viable Tp-incubating group and the inactived Tp-incubating group (P =0.127).Compared with TPPA,the sensitivity,specificity,consistency rate and area under the curve (AUC) of Tp0462-ELISA for the diagnosis of syphilis were 91.7％,98.8％,95.2％ and 0.997 respectively.Tp0462-ELISA was consistent to preliminary syphilis screening ELISA and RPR with a Kappa coefficient of 0.846 and 0.293,respectively.Conclusion Tp0462-ELISA has shown evidently higher sensitivity and specificity in the serodiagnosis of syphilis,and Tp0462 can serve as promising antigens for the diagnosis of syphilis.

Objective:Analyze the epidemiological data and the clinical data of local foodborne botulism, summarize the influencing factors and clinical characteristics of the foodborne botulism, mitigate future misdiagnosis.Methods:An epidemiological investigation was conducted to a local outbreak with botulism, which involved 24 individuals consuming homemade bean curd and 14 cases with foodborne botulism through analyzing the influencing factors of the poisoning. For 14 patients with botulism, their clinical manifestations, first laboratory test and imaging data, treatment and prognosis, were documented and explored.Results:All 14 cases were diagnosed as type A foodborne botulism, of which 2 were misdiagnosed. The incidence of the foodborne botulism was reduced by 81.7% in alcoholic drinkers ( P=0.009). The median incubation period of the 14 patients with botulism was 2.0 (1.0~3.0) days. The initial clinical symptom of 10 patients was diplopia, while that of the other 4 patients was blurred vision. Nine patients subsequently suffered from paralysis of oropharyngeal muscles, leading to dysphagia, speech impairment, etc. Four patients progressed to dyspnea and chest tightness due to respiratory muscle involvement. All of the patients had clear consciousness without sensory abnormalities, no fever and abdominal symptoms such as diarrhea and abdominal pain. There were no obvious abnormal findings in 14 patients with laboratory tests and cranial CT/MRI assessment. 14 patients with the poisoning were relieved after injection of botulinum antitoxin for 8.0 (7.0~8.5) days. Follow-up of all the patients 6 months later found that 9 patients still had slight blurred vision. Conclusions:The typical clinical manifestation of foodborne botulism was symmetric descending flaccid paralysis. Drinking liquor could reduce the incidence of foodborne botulism. Botulinum antitoxin was effective in the treatment of botulism and should be used as early as possible.

Abstract: Objective To investigate the impacts of blood pressure (BP) variability on neurological deterioration in patients with acute ischemic stroke after intravenous thrombolysis (IVT). Methods The clinical data of 134 patients after IVT in Department of Neurology, Affiliated jinhua Hospital, Zhejiang University School of Medicine from January 2020 to September 2020 were retrospectively analyzed, including hour-to-hour BP measurements. BP variability profiles, including average squared difference between successive measurements (sv), standard deviation (sd) were calculated. Early neurological deterioration (END) was defined as the National Institutes of Health Stroke Scale > 4 or death within 24 hour after IVT. The binary logistic-regression model was performed to determine the independent risk factors of END. Results Among134 patients, with mean age 67 year and median NIHSS 5,11 (8. 2%) patients achieved END. Compared with non-END group, END group has higher systolic BP sd (18 vs 14, t=-2.567,P=0.011),systolic BP sv (22 vs 17, t= -1.988, P=0.049). diastolic BP sd (13 vs 9.8.t= -2.431, P=0.016). Systolic BP sd, systolic BP sv and diastolic BP sd were related to the occurring of END independently. Conclusions SP variability is negatively associated with neurological deterioration occurring within 24h following ischemic stroke with intravenous thrombolysis.