Objective To investigate the roles of sex hormones and T-cell phenotype in traumatic brain injury (TBI). Methods Within 12 hours, 1, 3 and 7 days after TBI, a dynamic observation and a correlative analysis were performed on CD4 + and CD8 + lymphocytes in the serum and on the changes of estradiol, progesterone and testosterone in the cerebrospinal fluid (CSF) and serum in all cases. Results The CD4 + and CD8 + lymphocytes were inhibited and decreased with injury severity. The estradiol and progesterone levels in serum and cerebrospinal fluid (CSF) increased within 12 hours after trauma in all groups. Estradiol increased markedly continuously within 1, 3 and 7 days and progesterone sustained high within seven days in GCS≤8 group, with a significant difference compared with others groups. The testosterone levels in serum and CSF decreased in the death group. There was a positive correlation between the changes of CD4 + lymphocytes and the levels of serum estradiol, progesterone and testosterone in the death group. Conclusions The increases of estradiol (in the early stage) and progesterone (in the late stage) after TBI may exert powerful protective effects on brain tissues. Decreases of sex hormones and T lymphocyte are important factors leading to death of patients.

OBJECTIVE:To provide references for the legislation of Licensed Pharmacist Legislation. METHODS:Several misunderstandings appearing during the complementation of licensed pharmacist regulation were analyzed, as well as the reasons for these misunderstandings. RESULTS&CONCLUSION: The misunderstandings in the respect of legislative subjects, licensed posts, licensed treatment, talent market demand and further education should be avoided in the process of Licensed Pharmacist Legislation.

Objective To compare the clinical value of two kinds of imaging methods including CT and MRI in early diagnosis of acute multiple cerebral infarction. Methods The imaging data of CT and MRI of 108 patients with acute multiple cerebral infarction were analyzed. The total detection rate, the detection rate in different time periods,the number and area of detected lesions and the inspection time of CT and MRI in early diagnosis of acute multiple cerebral infarction were compared. Results The total detection rates of patients with acute multiple cerebral infarction by CT and MRI were 57. 41%,96. 30%,respectively. The total detection rate of MRI was significantly higher than CT(χ2 =9. 73,P<0. 05). The detection rates of patients with acute multiple cerebral infarction for onset within 24h and 24-72h by MRI were significantly higher than CT(χ2 =18. 54,16. 20,all P<0. 05). There was no significant difference in detection rate of patients with acute multiple cerebral infarction for onset >72h between CT and MRI(P>0. 05). The number of detected lesions of patients with acute multiple cerebral infarction by MRI was significantly more than CT(t=2. 39,P<0. 05). The area of detected lesions and the inspection time of patients with acute multiple cerebral infarction by MRI were significantly less than that by CT(t =2. 43,2. 60,all P <0. 05). Conclusion Compared with CT, MRI in the early diagnosis of acute multiple cerebral infarction can effectively improve the detection rate in early stage, avoid the missed diagnosis of small lesions and is helpful to shorten the examination time.

The incidence of venous thromboembolism（VTE）in patients with traumatic brain injury（TBI）, especially in patients with severe TBI, is significantly increased due to disturbance of consciousness and limb movement. In the acute phase of VTE, low molecular weight heparin（LMWH）is the most commonly used safe and effective measure to prevent thrombosis. Due to the changes of injury condition of trauma patients, the deviation of clinicians' understanding of VTE and the medication habits of various medical institutions, there are significant differences in the initial time and dose of LMWH prevention. Insufficient or excessive dose of LMWH will lead to thrombus or bleeding complications. In recent years, administration of LMWH with anti-X activity monitoring has been paid more and more attention in patients with TBI, playing an important role in reducing the incidence of thrombosis. The authors review the research progress in the application of LMWH with anti-X activity monitoring in thrombus prevention in patients with TBI from the aspects of mechanism in LMWH use with anti-X activity monitoring, LWMH medication time window and anti-X activity monitoring, LWMH dose adjustment and anti-X activity monitoring, in order to provide references for clinical treatment.

Objective:To explore the antagonistic effect of Fengzhecao extract against human red blood cell (RBC) hemolysis induced by wasp venom.Methods:Water extract method was used to extract dried Fengzhecao and vacuum-dried to obtain Fengzhecao extract. It was diluted into 1 g/L for next use. Wasp venom was collected from the wasp workers. A, B, O, AB type healthy blood donors' suspended RBC solution was obtain to make washed RBC solutions and adjust the RBCs count (4.0-80.0)×10 9/L (the number of RBC counted on the hemocytometer is 1-20 cells/small checker). According to treatment factors, they were divided into the normal saline controlled group (NS group; 200 μL RBC solution+20 μL normal saline), Fengzhecao extract group (FZC group; 200 μL RBC solution+10 μL Fengzhecao extract+10 μL normal saline), wasp venom group (FD group; 200 μL RBC solution+10 μL wasp venom+10 μL normal saline), and Fengzhecao extract+wasp venom group (FCD group; 200 μL RBC solution+10 μL Fengzhecao extract+10 μL wasp venom), with 10 blood samples per group of every blood type. The solutions were put into the glass test tube respectively, and then into 37 ℃ water bath thermostat. After 10 minutes, the blood cell counting plate was directly observed under the microscope and the RBCs was counted. Differences in RBC count was compared between the same treatment factors of different blood types and between different treatment factor groups of the same blood type. Results:There was no statistically significant difference in RBC count between blood types under the same treatment factors. The RBC count (×10 9/L) of the type A, B, O, AB in the NS group were 5.567±1.368, 5.146±1.690, 4.577±0.774, 5.197±1.587 ( F = 0.852, P = 0.475), the FZC group were 5.751±1.489, 5.268±1.418, 4.727±1.174, 5.298±1.229 ( F = 0.987, P = 0.410), the FD group were 0.546±0.450, 0.804±0.428, 0.679±0.283, 0.846±0.453 ( F = 1.089, P = 0.366), and the FCD group were 5.532±1.330, 5.051±1.596, 4.589±0.879, 5.140±1.492 ( F = 0.820, P = 0.492), respectively. Comparison of RBC count between groups with different treatment factors of the same blood type was done. There was no significant difference between the FZC group and the NS group, indicating that the extract of Fengzhecao extract had no effect on hemolysis of RBC; in the FD group, it was significantly lower than the NS group (all P < 0.05), indicating that wasp venom had a significant hemolytic effect on RBC; but there was no statistically significant difference in RBC count between the FCD group and the NS group, indicating that the Fengzhecao extract antagonizes the hemolytic effect of wasp venom without affecting the RBC count; however, the RBC count in the FCD group was significantly higher than that in the FD group (all P < 0.05), further indicating that the Fengzhecao extract antagonizes the hemolytic effect of wasp venom. Conclusion:Wasp venom has a significant hemolytic effect which can be effectively antagonized by Fengzhecao extract and has nothing to do with the human ABO blood type.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.