Professor ZHANG Lei is one of the most renowned doctors in traditional Chinese medicine. He is good at treating miscellaneous disease of internal medicine, and summarizes eight clinical therapy from long-term clinical practice, and cleaning turbidity therapy is one of the most characteristic therapy. Cleaning turbidity therapy is founded under today's improvement of living standards and changes of lifestyle where more and more turbidity syndromes are caused. Qianjin Weijing Decoction is used as main prescription and modified according to different zang-fu where turbidity syndromes are located. On account of cleaning turbidity therapy is one of the eliminating pathogens therapy, strengthening healthy qi must be used according to power of healthy qi, especially healthy qi of spleen and stomach.

Ten pregnant rats randomly chosen from the total twenty rats on day 9 ofprognancy were injected a high dosage of LRH-A.The other ten were used ascontrol group.After one day and two days the ultrastructure of the luteal cell wasobserved by transmission electron microscope.Compared with the control group,theexperimental group showed an increase of lipid droplets,and a lot of large lipiddroplets appeared.The smooth endoplasmic reticulum decreased,dissolved and lostits regular array.Mitochondria degenerated,Autophagocytic vacuole,lysosome,myelin figure,multivesicular body as well as residual body increased.Golgi appa-ratus swelled in the first day after injection,and then shrank.Microvilli on thesurface of the cell decreased.The above results all suggest that with the injection of high dosage of LRH-Ainto the pregnant rats,luteal cell shows morphologic regression and decrease insecretive function.

In the present experiment the high dose of LRH-A was injected into pregnant rats on Day 9 of pregnancy. Morphology and histochemistry of corpus luteum were studied. It was found that 24 hours after injection LRH-A could effectively cause the corpus luteum to degenarate. A great many large lipid droplets occured in the luteal cells, and the activity of 3?-HSD and of SDH of these cells decreased. At the same time the activity of AcP increased in a few of luteal cells. 48 hours after injection the effects outlined above became more distinct, and the activity of G-6-PD also began to decrease. The activity of 20 ?-HSD in both control and experimental groups was negative 24 hours after injection, while the activity of the AIP increased distinctly in endothelium of the capillary network of corpus luteum. These changes indicated that the high dose of LRH-A had damaged corpus luteum and reduced its synthetic and secretory function of progesterone which, we believe, plays a main role in terminating pregnancy.

The specific anti-rat LH, anti-rat FSH and anti-hCG sera were used in the peroxidase antiperoxidase (PAP) immunohistochemical method to observe the change of pituitary gonadotropic cells in pregnant rats after being injected by a high dosage of LHRH-A. It was observed that 24 hrs after injection the immunohistochemical reaction of gonadotropic cells weakened strikingly; 48 hrs after injection the immunohistochemical reaction began to recover; and 168 hrs after injection, the recovery was still in progress. The number of LH cells of different immunoreactive intensity and their percentage in total LH cells of the control and experimental groups were calculated and tested by statistical method. It was found that the results were the same as the above. Our observations support the view that the high dosage of LHRH-A can stimulate gonadotropic cells in rat to release a great amount of LH rapidly. It inhibits the synthesis of progesterone in the ovary of pregnant rat and results in termination of pregnancy. Moreover it is believed that the effect of high dosage of LHRH-A on the secretory function of gonadotropic cells can recover themseleves.

24 cases of human placentas were obtained from rivanol-induced abortion, and 6 cases from cesarean section, curettage, and water saccule-induced abortion were chosen for comparative study. All the specimens were proccessed under the same histological and histochemical procedures.In all the specimens from rivanol-induced abortion we observed a reduction in the activity of the ?~5-3?-hydroxysteroid dehydrogenase and of the number of fine lipid droplets in the syncytiotrophoblasts, and in these cells we also observed an increased activity in acid phosphatase in most of the specimens and a decrease of RNA content in a few specimens. A large number of decidual cells and a few trophoblasts showed necrotic changes. The chorionic plate also showed necrosis and distinct inflammatory reactions, and on the fetal surface of the placenta the blood circulation showed disturbance. These changes indicated that rivanol had demaged the placenta and reduced its synthetic function of progesterone which we believed played a rote in terminating pregnancy and caused abortion eventually. It was suggested that the intraamniotic injection of rivanol is preferable to extraamniotic injection.

Objective:To explore the mechanism of turnover intention of junior nurses after adverse events from three aspects: work pressure, leadership style and personal characteristics.Methods:This study was a cross-sectional survey, using the convenience sampling method, 289 nurses from Shanxi Bethune Hospital from December 2020 to March 2022 were selected as the research subjects, and the general data questionnaire, the Separation Tendency Scale, the Nurses′ Work Stressor Scale, the Service-oriented Leadership Style Scale, and the Prospective Personality Scale were used to survey them.Results:Structural equation model showed that nurses′ job stressor level positively predicted turnover intention, with a path coefficient of 0.74, P<0.01, while service-oriented leadership style and forward-looking personality negatively predicted turnover intention, with path coefficients of -0.60 and -0.37, respectively, both P<0.01. Hierarchical regression analysis showed that both service-oriented leadership style and forward-looking personality negatively moderated the promotion of job stressors on turnover intention, and the moderating effect regression coefficients were -0.146, -0.215, both P<0.01. Conclusions:Hospitals should improve the prospective personality traits of junior nurses and cultivate the service-oriented leadership style of nursing managers after adverse events, so as to reduce the turnover tendency of junior nurses as the second victim, promote the improvement of nursing quality, and stabilize nursing team development.

OBJECTIVES: The long-term trends of cognitive function and its associations with physical performance remain unclear, particularly in Asian populations. The study objectives were to determine cognitive trajectories in middle-aged and elderly Chinese individuals, as well as to examine differences in physical performance across cognitive trajectory groups. METHODS: Data were extracted from the China Health and Retirement Longitudinal Study. A total of 5,701 participants (47.7% male) with a mean age of 57.8 (standard deviation, 8.4) years at enrollment were included. A group-based trajectory model was used to identify cognitive trajectory groups for each sex. Grip strength, repeated chair stand, and standing balance tests were used to evaluate physical performance. An ordered logistic regression model was employed to analyze differences in physical performance across cognitive trajectory groups. RESULTS: Three cognitive trajectory groups were identified for each sex: low, middle, and high. For both sexes, higher cognitive trajectory groups exhibited smaller declines with age. In the fully adjusted model, relative to the low trajectory group, the odds ratios (ORs) of better physical performance in the middle cognitive group were 1.37 (95% confidence interval [CI], 1.17 to 1.59; p<0.001) during follow-up and 1.40 (95% CI, 1.20 to 1.64; p<0.001) at the endpoint. The ORs in the high trajectory group were 1.94 (95% CI, 1.61 to 2.32; p<0.001) during follow-up and 2.04 (95% CI, 1.69 to 2.45; p<0.001) at the endpoint. CONCLUSIONS Cognitive function was better preserved in male participants and individuals with higher baseline cognitive function. A higher cognitive trajectory was associated with better physical performance over time.

OBJECTIVETo explore the efficacy prediction of the locally advanced rectal cancer patients, especially those with pathological complete response(pCR), receiving neoadjuvant chemoradiotherapy in order to execute precise preoperative neoadjuvant chemoradiotherapy.

METHODSFrom January 2000 to January 2011, 125 patients diagnosed as locally advanced rectal cancer receiving preoperative neoadjuvant chemoradiotherapy in our department with complete data were enrolled in this study, including 85 males and 40 females with mean age of 54(15 to 77) years old. All the patients received radiotherapy with 46 Gy(23 times) and administered XELOX regimen (oxaliplatin 100 mg/m(2) plus capecitabine 2 000 mg/m(2)) for 2 courses simultaneously, and underwent radical operation 6 to 8 weeks after chemoradiotherapy. The data of these patients were analyzed retrospectively. Pathological remission was divided into 4 grades. Patients achieving grade 4 were defined as pCR, and those achieving above grade 2 were defined as better response. Logistic regression analysis was used to identify significant predictors of pCR.

RESULTSAmong 125 patients, 16(12.8%) achieved pCR status, and 90(72.0%) had better response to the neoadjuvant chemoradiotherapy. Logistic regression analysis showed that age(OR:1.060, P=0.037) and preoperative positive lymph nodes detected by endorectal ultrasonography (OR:0.059, P=0.006) were independent predictors of pCR after neoadjuvant chemoradiotherapy.

CONCLUSIONSPreoperative existence of lymph node metastasis around bowel indicates the poor response to neoadjuvant chemoradiotherapy. Age is associated with pCR in patients receiving neoadjuvant chemoradiotherapy.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Capecitabine ; therapeutic use ; Chemoradiotherapy ; Deoxycytidine ; analogs & derivatives ; therapeutic use ; Female ; Fluorouracil ; analogs & derivatives ; therapeutic use ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms ; therapy ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the impact of femoral prosthesis malposition on internal structural strain in unicompartmental knee arthroplasty for osteoporotic knees.Methods A normal bone knee joint model was constructed based on imaging studies(CT,magnetic resonance imaging)of healthy volunteers,and an osteoporotic knee joint model was constructed by altering the elastic modulus.Finite element models of femoral prosthesis malposition in unicompartmental knee arthro-plasty were then established for both normal bone and osteoporotic groups.A vertical static load of 1,000 N was applied to both models,and the peak strain values and distributions were observed in the medial compartment structures(polyethylene gasket,cancellous bone under tibial prosthesis)and lateral compartment structures(meniscus,tibial cartilage)at various malposition angles of the femoral prosthesis.Results The peak strain values of the polyethylene gasket,cancellous bone under tibial prosthesis,meniscus,and tibial cartilage in the osteoporotic group were higher than those in the nor-mal bone group at different varus and valgus angles.In the osteoporotic group,the peak strain values of the polyethylene gasket and cancellous bone under tibial prosthesis increased with the increase in fem-oral prosthesis malposition angle,with a greater increase at valgus angles than at varus angles.Similarly,the peak strain values of the meniscus and tibial cartilage increased with the increase in femoral prosthesis malposition angle,but the increase was greater at varus angles than at valgus angles.The strain concentration area of the polyethylene gasket was located in a circular-like area where the fem-oral prosthesis contacted the gasket,the strain concentration area of the cancellous bone was mainly located in the posterolateral region,the strain concentration area of the meniscus was located near the anterior horn,and the strain concentration area of the tibial cartilage was mainly located in the middle near the intercondylar eminence.Conclusion Osteoporosis may adversely affect the strain on internal structures of the knee joint after unicompartmental knee arthroplasty.Varus malposition of the femoral prosthesis may exacerbate the progression of osteoarthritis in the contralateral compart-ment(lateral compartment),while valgus malposition may increase the risk of prosthesis loosening and revision surgery.

Objective To investigate the impact of femoral prosthesis malposition on internal structural strain in unicompartmental knee arthroplasty for osteoporotic knees.Methods A normal bone knee joint model was constructed based on imaging studies(CT,magnetic resonance imaging)of healthy volunteers,and an osteoporotic knee joint model was constructed by altering the elastic modulus.Finite element models of femoral prosthesis malposition in unicompartmental knee arthro-plasty were then established for both normal bone and osteoporotic groups.A vertical static load of 1,000 N was applied to both models,and the peak strain values and distributions were observed in the medial compartment structures(polyethylene gasket,cancellous bone under tibial prosthesis)and lateral compartment structures(meniscus,tibial cartilage)at various malposition angles of the femoral prosthesis.Results The peak strain values of the polyethylene gasket,cancellous bone under tibial prosthesis,meniscus,and tibial cartilage in the osteoporotic group were higher than those in the nor-mal bone group at different varus and valgus angles.In the osteoporotic group,the peak strain values of the polyethylene gasket and cancellous bone under tibial prosthesis increased with the increase in fem-oral prosthesis malposition angle,with a greater increase at valgus angles than at varus angles.Similarly,the peak strain values of the meniscus and tibial cartilage increased with the increase in femoral prosthesis malposition angle,but the increase was greater at varus angles than at valgus angles.The strain concentration area of the polyethylene gasket was located in a circular-like area where the fem-oral prosthesis contacted the gasket,the strain concentration area of the cancellous bone was mainly located in the posterolateral region,the strain concentration area of the meniscus was located near the anterior horn,and the strain concentration area of the tibial cartilage was mainly located in the middle near the intercondylar eminence.Conclusion Osteoporosis may adversely affect the strain on internal structures of the knee joint after unicompartmental knee arthroplasty.Varus malposition of the femoral prosthesis may exacerbate the progression of osteoarthritis in the contralateral compart-ment(lateral compartment),while valgus malposition may increase the risk of prosthesis loosening and revision surgery.