Objective To observe the influence of Shenmai injection for the postoperative infection and related serum indexes of patients with breast cancer,in order to provide evidence for the prevention of patients'postoperative infection.Methods 90 patients with breast cancerwere selected as the study object,and all the patients were randomly divided into control group(conventional postoperative treatment group)45 cases and observation group (conventional treatment and Shenmai injection group)45 cases,then the postoperative infection rates,inflammatory indexes and immune indexes before the treatment and after the treatment at different time were compared .Results The total postoperative infection rate of observation group was one case (2.22%),and it had no obviously difference compared with four cases (8.89%) of control group,the inflammatory indexes including PCT, TNF-α, IL-6 and hs-CRP at first,third and seventh day after the treatment were all lower than those of control group ,the immune indexes including CD3 +、CD4 +、CD8 +及 CD3 +CD4 +were all better than those of control group ( all P<0.05 ) .Conclusion The Shenmai injection can effectively control the postoperative infection rate of patients with breast cancer,and it also plays active improvement role for the infection related indexes.

Objective To evaluate the value of electronic video endoscopy for adults in upper gastrointestinal disease in children. Methods Results of video endoscopy for adults performed on 128 children with abdominal pain, upper gastrointestinal hemorrhage, accidental foreign bodies, and esophageal stenosis were analyzed retrospectively. Results The total positive detection rate was 100%. The incidence rates of chronic superficial gastritis and/or duodenitis, peptic ulcer, and foreign bodies were 64.84%, 25.78%, and 8.59%, respectively. Only 1 case of esophageal stenosis was found. Conclusion Video endoscopy for adults, also safe for children, is of significant value in the etiological diagnosis of upper gastrointestinal disease in children.

Objective To compare the value of NBI with magnify endoscopy (NBI-ME) and Lugol chromoendoscopy (LCE) in preoperative assessment of early esophageal cancer, and assess whether the former can replace the latter. Methods 59 patients, sampled in the Second Hospital of Lanzhou University, the First Hospital of Lanzhou University and the Second Hospital of Lanzhou City from January 2014 to December 2015, were examined respectively by NBI-ME and Lugol chromoendoscopy not only to distinguish the lesion boundaries but also predict the pathological types as well for statistical analysis with the combination of the final postoperative pathological results. Results Only 64.4 % (38/59) of lesion boundaries can be well-distinguished by NBI-ME, which is significantly lower than that distinguished by Lugol chromoendoscopy (91.5 %, 54/59), with its kappa value 0.208< 0.4, P < 0.01 (0.006). It indicated that poor concordance existed in these two methods. The McNemar value which reflects concordance between pathological type predicted by NBI-ME and postoperative pathology was diagnosed to be 5.397, P > 0.05 (0.369), Kappa > 0.4 (0.429), P < 0.01 (0.000), suggesting the concordance can be acceptable. However, the McNemar number diagnosed by Lugol chromoendoscopy was only 4.533, P > 0.05 (0.475), Kappa <0.4 (0.286), P < 0.01 (0.001), showing the poor concordance instead. Conclusions To some extent, pathological type predicted by NBI-ME indeed had an concordance with postoperative pathology, which was also superior to the results examined by Lugol chromoendoscopy, while there was no denying that Lugol chromoendoscopy had an obvious advantage over NBI-ME in terms of distinguishing lesion boundaries, therefore, it can not be completely replaced with NBI-ME at present.

OBJECTIVE:To investigate the application of fuzzy comprehensive evaluation in formulation screening. METH-ODS:Taking Compound paracetamol and chlorphenamine maleate granules as model drug,based on single factor experiment,L9(34) orthogonal test was used to screen the formulation with the amount of aspartame,hawthorn powder essence,milk powder essence and saccharose as factors,using dissolution rate of caffeine as index. The granules prepared by 9 kinds of formulation in orthogonal test were evaluated with fuzzy comprehensive evaluation in terms of taste,aroma,color and dissolubility. The optimized formula-tion was validated and compared with original formulation. RESULTS:The formulation 5 was the optimal choice in both orthogo-nal test and fuzzy comprehensive evaluation,and obtained same results. Compared with sensory comprehensive score (63.12) and dissolution rate of caffeine (91.3%) in original formulation,two indicators of optimized formulation in 3 tests were 84.00 and 99.07% in average (RSD<2.0%,n=3). CONCLUSIONS:Fuzzy comprehensive evaluation can be used for the formulation screening of sensory evaluation index. It is scientific and accurate.

Objective To explore the effect of iliac bone flap combined with cancellous bone graft in the treatment of traumatic avascular necrosis of the femoral head (TFHIN). Methods The patients were treated with iliac bone flap and cancellous bone graft. The operation time, intraoperative blood loss, fracture healing time, follow-up time and the postoperative complications were recorded.The degree of hip movement (flexion, external rotation, internal rotation, abduction and adduction) was recorded;the hip functions of patients with different stages were analyzed;the long-term curative effect of postoperative was analyzed. Results The operation time was (68.36 ± 6.81) min, intraoperative blood loss was(93.65 ± 10.42)ml, fracture healing time was(4.31 ± 1.25)months, follow-up time was 35-62 (48.92 ± 2.61)months, and the postoperative complication was 1.42%(3/212).The scores of hip function were significantly improved in each postoperative stage, joint flexion, external rotation, internal rotation, abduction and adduction range was significantly expanded: (94.86 ± 12.37)° vs. (118.24 ± 15.25)°, (32.07 ± 10.34)° vs. (43.64 ± 10.82)°, (28.33 ± 9.61)° vs. (33.41 ± 11.85)°, (19.44 ± 8.37)° vs. (24.36 ± 7.65)°, and the differences were statistically significant (P<0.05). At the last follow-up, the total excellent and good rate of hip function recovery was 88.74%(205/231).The stability rate of imaging was 80.09%(185/231). Conclusions In patients with TFHIN, treatment with the iliac bone flap pedicled with cancellous bone could the blood pressure of the femoral head, restore the blood supply to the damaged site, participate in the bone induction, and improve the hip movement and function,which has a good effect.

Objective:To compare the post-operative outcomes between extended lateral approach and L-shaped lateral approach in surgical treatment of Sanders type III intra-articular calcaneal fractures.Methods:A retrospective case-control study was made on clinical data of 34 patients with fresh Sanders type III intra-articular calcaneal fractures hospitalized in Langfang Hospital of Traditional Chinese Medicine from October 2014 to October 2017. There were 33 males and 1 female, with the age of 18-56 years [(42.5±9.4)years]. All fractures were fresh. Seventeen patients were fixed by the extended lateral approach (extended approach group) and seventeen patients by L-shaped lateral approach (L-shaped approach group). Operation duration, intraoperative bleeding volume, length of hospital stay, one-stage wound healing rate and complication rate were observed. B?hler and Gissane angle were measured before operation, one week after operation and 12 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was applied to evaluate function recovery.Results:There were no significant differences between groups in operative time and intraoperative bleeding volume ( P>0.05). There were significant differences between extended approach group and L-shaped approach group in length of hospital stay [(15.7±4.0)days vs.(22.4±9.6)days], one-stage wound healing rate [88%(15/17) vs. 47%(8/12)] and postoperative complication rate [12%(2/17) vs. 47%(8/17)] ( P<0.05). The B?hler and Gissane angles did not differ significantly between groups before operation and one week and 12 months after operation ( P>0.05). At postoperative 12 months, the B?hler and Gissane angles were improved from preoperative (8.2±6.0)°, (85.3±10.5)° to (23.9±6.1)° and (119.3±6.2)° respectively in extended approach group, and those from preoperative (9.4±3.9)°, (85.5±7.1)° to (25.8±3.7)° and (122.2±5.6)° respectively in L-shaped approach group (all P>0.05). At 12 months after operation, the AOFAS score was (86.9±7.5)points in extended approach group, with the excellent and good rate of 88%; and was (83.3±12.5)points in L-shaped approach group, with the excellent and good rate of 76% ( P>0.05). While the score of hindfoot joint activity in extended approach group was (5.8±0.7)points, significantly higher than (3.4±1.0)points in L-shaped approach group ( P<0.05). Conclusion:For Sanders III intraarticular calcaneal fractures, compared with L-shaped approach group, plate fixation via extended approach can promote fracture healing, shorten hospital stay, reduce incidence of complications and facilitate function recovery of subtalar joint.

As a kind of class II medical device, medical optical radiation protective eyewears should meet the requirements of safety and effectiveness. In this study, the evaluation system of medical optical radiation protective eyewears is established. Combined with the medical device registration unit division guidelines, the classification method of medical optical radiation protective eyewears is given. Medical optical radiation protective eyewears are not only assembled spectacles, but also have special optical radiation protection performance. The performance evaluation method of medical optical radiation protective eyewears and the evaluation method of shelf life for medical optical radiation protective eyewears are given.
Radiation Protection

Objective:To explore the effect of diet safety management based on swallowing function classification in perioperative period of elderly patients with hip fractures, so as to provide basis for improving perioperative food safety and shortening hospitalization time of patients with hip fracture.Methods:A total of 68 elderly patients with hip fractures in the First Medical Center of PLA General Hospital from December 2020 to August 2021 were selected and divided into experimental group and control group according to even and odd-number of admission number, each group contained 34 patients. The control group was given routine diet nursing and food safety education. The experimental group was given graded diet safety management according to the swallowing function evaluation results. The incidence of aspiration and length of hospital stay were compared between the two groups.Results:The incidence of chocking during hospitalization was 5.1% (78/1 517) in the control group and 1.2% (17/1 402) in the experimental group, and the difference was statistically significant ( χ2=35.73, P<0.01). The incidence of choking in the control group was 0.7% (11/1 517), and 0.4% (5/1 402) in the experimental group, and the difference was not statistically significant ( χ2=1.82, P>0.05). There was no significant difference in hospitalization time between the two groups, 10 (8,12) in the control group and 9 (8,11) in the experimental group ( Z=-1.33, P>0.05). Conclusions:The implementation of diet safety management based on swallowing function classification in elderly patients with hip fractures can reduce the incidence of coughing. Evaluation of swallowing function should be included in the evaluation of hip fractures in the elderly.

Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.