BACKGROUND: The complex prescription of lujiao prescription is made up of antle, malytea scurfpea fruit, korean epimedium herb, dogwood, glossy privet fruit, and Chinese eaglewood wood. It is characterized by its positive myodynamia as well as promoting diuresis and expanding vessels. OBJECTIVE: To observe the effect of lujiao prescription in reversing left ventricular remodeling in rats with pressure overload. DESIGN: A randomized controlled trial. SETTING: Department of Integrated Traditional Chinese Medicine and Western Medicine, Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA; Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine; Postdoctor Institute of Hebei Medical University.MATERIALS: The experiment was conducted at the Laboratory of Shanghai University of Traditional Chinese Medicine from January to December 1998. Totally 153 male Wistar rats were provided by the Experimental Animal Center of Shanghai Medical College. There were five experiments with 36 rats selected for each experiment except 9 rats for the fourth one.METHODS: Totally 36 Wistar male rats selected for each experiment were randomly divided into sham operation group, model group and lujiao prescription group. Sham-operation group: The rats' abdominal aortas were separated, but not narrowed by silver clip. After four weeks, the rats were treated with twice-distilled water (15 mL/mg, ig), once a day for 4 consec utive weeks. Model group: Four weeks after modeling, the rats were treated with twice-distilled water (15 mL/mg, ig) once a day for 4 consecutive weeks. Lujiao prescription group: Four weeks after rat modeling, the ratswere given orally liquid decoction of lujiao prescription (15 mL/mg, ig),once a day for 4 weeks. Observations on left ventricular mass index (LVMI): Collagen type Ⅰ and Ⅲ was measured by immunohistochemistry. mRNA expression of collagen type Ⅰ and Ⅲ was measured by RT-PCR. Ang Ⅱ, ANF and ALD were measured by radioimmunoassay. MAIN OUTCOME MEASURES: LVMI, left ventricular myocardium collagen type Ⅰ and Ⅲ, mRNA expression of collagen type Ⅰ and Ⅲ, and changes of plasm, myocardium Ang Ⅱ, plasm ANF and serum aldosterone.RESULTS: Totally 153 rats entered the final analysis. During the detection of mRNA expression of collagen type Ⅰ , 3 rats in sham-operation group died and 1 in lujiao prescription group died. The other 29 rats en tered the final analysis. During the detection of mRNA expression of collagen type Ⅲ, 3 rats in sham-operation group died, 3 in lujiao prescription group died, and 6 in model group died. The other 26 rats entered the final analysis. All rats were lost because of operation injury. ① LVMI: It was lower in sham-operation group and lujiao prescription group than in model group [(2.24±0.12)/1 000, (2.60±0.44) /1 000, (3.15±0.47)/1 000,t=2.959-6.499, P < 0.05]. ② Changes of absorbency of collagen type Ⅰ :It was lower in sham-operation group and lujiao prescription group than in model group [(0.56±0.23, 0.57±0.19, 2.79±2.00), t=0.661-3.964,P < 0.01]. ③ Changes of absorbency of collagen type Ⅲ: It was lower insham-operation group and lujiao prescription group than in model group [(0.48±0.10,0.55±0.09,0.84±0.27), t=2.898-3.560, P < 0.01]. ④ mRNA expression of collagen type Ⅰ: It was lower in sham-operation group and lujiao prescription group than in model group [58.0±36.0)%, (79.1±18.6)%,(139.0±29.2)%, t=3.027, P < 0.05]. ⑤ Changes of myocardium Aug Ⅱ: It was lower in sham-operation group and lujiao prescription group than in model group [(2.49±0.57, 2.64±0.57,3.96±0.77) pg/mL, t=4.773-5.315,P < 0.001]. ⑥ Changes of serum aldosterone: It was lower in sham-operation group and lujiao prescription group than in model group [(501.6±94.6,476.6±85.7, 647.8±72.2) ng/mL, t=4.256-5.292, P < 0.001].CONCLUSION: Indexes of integrating absorbency of myocardial collagen type Ⅰ and type Ⅲ, mRNA expression of collagen type Ⅰ , myocardial Aug Ⅱ and serum aldosterone are all similar to the changes LVMI. Lujiao prescription can reverse left ventricular remodeling and myocardial fibrosis.

Liver-injury caused by chemicals is a common question in modern clinic. Professor LI Ping proposes ‘drug yellow’theory to guide TCM differential treatment. In this paper, the author will analyze the chemicals by the proved cases of drug-induced severe liver damage.

BACKGROUND: The investigation of culturing, passaging and establishing human limbal stem cells can strengthen the recognition of the stem cells and provide the enough cellular reserve for the basic and clinical research of limbal stem cell transplantation.OBJECTIVE: To explore a method of pessaging and establishing cell line of human limbal stem cells cultured in vitro.DESIGN: Randomized controlled observation.SETTING: Gannan Medical College.MATERIALS: The experiment was performed at Scientific Center of Gannan Medical College and the National Key Laboratory of Ophthalmology Hospital Affiliated to Sun Yat-Sen University from June 2003 to April 2004. Fresh human limbus corneae were isolated from two healthy donors. Procedures were performed according to the informed consent of the donors. Main reagents contained RPMI-1640 (Sigma R8755, containing L-glutamine) and 200 g/L fetal calf serum (FCS) (Gibco 16140-071). DMEM medium, chondroitin sulfatase and human epidermal growth factor (hEGF) were purchased from Sigma Co. USA; HEPES and DMSO were bought from Gibco, USA; 100% glycerinum was purchased from Yunjia Huangpu Pharmaceutical Product Limited Company, PRC; glutaraldehyde was bought from E.Merk, Germany; Alcohol, chlorhydric acid, acetone and methyl aldehyde were purchased from Beijing Chemical Agent Company, PRC; 0.25% parenzyme was bought from Shanghai Xinhua Pharmaceutical Factory, PRC.Above-mentioned reagents were analytical pure grade.METHODS: After digestion, human limbal tissues in limbal basilar part with an abundant pigment were cultured in the culture flask containing RPMI-1640 and 200 g/L FCS and in culture dish containing amniotic extracellular matrix (AECM) as the cultural supporter. Primary and passage cells were observed under light microscope and scanning electron microscope (SEM). The revival ratio of stem cell refrigeration of every generation was calculated by the trypanblau exclusion experiment.MAIN OUTCOME MEASURES: ① Observational results of limbal stem cells during the primary culture and serial subcultivation in vitro, and ② revival ratio of stem cell refrigeration.RESULTS: ①Findings of primary culture: Most limbal stem cells in the culture flask had the adherence and were arrayed uniformly sparsely to form monolayer and adhered to the bottom of culture flask under the inverted phase contrast microscope after 1-day culture. ② Findings of serial subcultivation: After human epidermal growth factor (hEGF) was added into the second passage, cells were scattered into the monolayer and adhered to grow quickly.Morphological variability of all the cells increased obviously when passage the 30th generation. The cellular volume was obviously increasing, and the round or irregular round cells gathered together. The 33rd generation human limbal stem cells still could vigorously differentiate, proliferate and grow in ACEM. ③ The revival ratio of stem cell refrigeration was 82.2%.CONCLUSION: The human limbal stem cell lines were preliminarily established by culturing and freezing the cells of 33 generations in vitro. The human limbal stem cell lines preferred to grow in the culture dish containing AECM as the cultural supporter.

Objective To explore the effect of the clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for undergraduate nursing students.Methods Totally 87 undergraduate nursing students were enrolled and divided into the experimental group (n=44) and the control group (n=43).The experimental group received clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for communication.The control group received traditional class-based education for communication.The chnical communication skills questionnaire and Communication Observing Questionnaire were administered before and after the training.The testing results of both groups were compared.Results After participating in the education project,six dimensions of clinical communication competence and the total score were significantly improved after training compared with those before training in the experimental group.After training,the experimental group was better than the control group in establishment of harmonious relationship,confirming patients' problems,efficient information transfer,validation experience and communication competence,t values were 2.64,2.32,2.19,2.20 and 4.36,P＜ 0.05.In testing of integrated cases,scores of six aspects such as case design,information collection,explaining behavior,relationship development,conflict coordination and service behavior in the experimental group were significantly higher than those of the control group,t values were 2.15,2.10,3.26,2.84,2.14 and 2.61,P＜0.05.Conclusions The clinical scenario-based simulation education based on the Calgary-Cambridge Guide can improve communication competence of nursing students.

Aim To identify alteration in key molecular components related to memory formation and insulin signaling in the hippocampus after rosiglitazone was in-jected into the ob/ob mice to test whether cognitive dysfunction was pharmacologically reversed by regula-tion of rosiglitazone. Methods The age-matched mice were divided into three groups ( n=18 ): Saline-trea-ted WT mice ( WT-Saline);Saline-treated ob/ob mice ( ob/ob-Saline) and RSG-treated ob/ob mice ( ob/ob-RSG) through intraperitoneal injection of rosiglitazone ( RSG) . The random glucose levels were measured for 10 days during the intraperitoneal injection period. No-vel object recognition was performed before mice were sacrificed. Western blot was implemented to evaluate the following proteins: BACE1, p-Tau, p-IRS1,IRS1, p-Akt and Akt in hippocampal tissues. The Aβ1-40 levels were detected by ELISA Kit. Results The random blood glucose levels were significantly re-duced in ob/ob-RSG compared with ob/ob-saline. RSG treatment led to an increase in hippocampus-de-pendent cognition of ob/ob mice according to the novel object recognition. The proteins levels of BACE1, p-Tau and Aβ were lowered in RSG-treated ob/ob mice. Furthermore, RSG treatment up-regulated hippocampal p-IRS1/IRS1 and p-Akt/Akt ratio. Conclusion Ros-iglitazone ameliorates cognitive deficits in ob/ob mice through up-regulating insulin signaling pathways in the hippocampus.

Objective To observe the curative effect of traditional Chinese and western medicine in the treatment of functional delayed gastric emptying after major gastrectomy.Methods From March 2010 to March 2015, a total of 128 cases with gastric dissection of functional delayed gastric emptying after major gastrectomy in the Affiliated Hospital of Chengdu University of TCM were divided into control group ( n＝64) and observation group ( n ＝64) based on a random number table.The control group was given western medicine,the observation group was given traditional Chinese medicine combined with Western medicine.The clinical efficacy,gastric function recovery time of the two groups were compared.Results The gastric function recovery time in the observation group was (14.12 ±1.36)d, which was significantly shorter than (20.56 ±2.10)d in the control group,and the difference was statistically significant (P＜0.05).The total effective rate of the observation group (87.50%) was significantly higher than that of the control group (68.75%),and the difference was statistically significant ( P＜0.05).Conclusion Comprehensive therapy combined with western and Chinese medicine in the treatment of functional delayed gastric emptying after major gastrectomy has significant clinical effect ,which is worthy of further application.

OBJECTIVE: To assess the performance of non-invasive prenatal testing (NIPT) for the detection of fetal chromosomal aneuploidies and its value for the prevention of birth defects. METHODS: In total 28 033 pregnant women underwent NIPT test. The results were compared with that of amniotic fluid and cord blood chromosomal karyotyping analysis. A few cases were verified by array comparative genome hybridization (aCGH). All pregnant women and their fetuses were followed up until after birth. RESULTS: NIPT has indicated a high risk for fetal chromosomal aneuploidies in 186 cases (0.66%), among which 101 (67.33%) were confirmed as 21, 18 and 13 trisomies by invasive prenatal diagnosis, which yielded a diagnostic rate of 86.52%, 50.00% and 19.05%, respectively. The diagnostic rates were 81.28%, 67.85%, 62.79% and 76.00% respectively for those ≥40, ≥35, 25 to 34, and <25. And the diagnostic rates were 65.91%, 60.78%, 71.79% and 80.00% for those over 35, with high risk by prenatal screening, critical risk by prenatal screening and ultrasound abnormality, respectively. CONCLUSION The NIPT is effective for screening common chromosomal aneuploidies and preventing births of neonates with trisomy 21, trisomy 18 and trisomy 13.

Objective To evaluate the effects of kangaroo mother care (KMC) during cesarean section on neonatal health parameters in the "golden hour" of late preterm infants. Methods A total of 120 singleton pregnant women undergoing preterm cesarean section (34-36+6 gestational weeks) from January 1 to December 31, 2018 in Jiaxing Women and Children's Hospital Affiliated to Wenzhou Medical University were prospectively enrolled and divided into two groups (observation and control groups) with 60 cases in each by random number table method. During cesarean section, the both groups received the thorough drying immediately and delayed cord clamping, in addition, the observation group adopted KMC, while the control group received routine maternal and infant care. Several parameters including changes in body temperature, crying, respiration, oxygen saturation and other vital signs, as well as the incidence of hypothermia, transfer to the Department of Neonatology and the success rate of early breastfeeding initiation during the "golden hour" were compared between the two groups. Satisfaction of obstetricians, pediatricians, the pregnant women and their families to KMC and routine maternal and infant care were compared. Two-independent sample t test and Chi-square test were used as statistical methods. Results In total, 113 cases (58 in the observation group and 55 in the control group) were finally analyzed. The body temperature of the late preterm infants at 5 and 10 min after birth in the observation group was higher than that in the control group (36.5 vs 36.0 ℃, 36.4 vs 35.8 ℃, t=11.756 and 7.512, both P<0.05), and the body temperature during 15 min-1 h after birth was also higher in the observation group but without statistical significance (all P>0.05). The observation group had a lower incidence of hypothermia [0% (0/58) vs 15% (8/55), χ2=9.079, P<0.001] and a higher success rate of early breastfeeding initiation [86% (50/58) vs 58% (32/55), χ2=11.137, P<0.001] than the control group. The satisfaction scores of obstetricians (19.3±1.1 vs 13.4±1.9, t=20.517), pediatricians (18.2±1.8 vs 12.6±2.1, t=15.382), gravidas (19.6±0.4 vs 13.6±1.6, t=27.723) and their family members (18.2±0.9 vs 15.3±1.1, t=11.535) were all higher in the observation group than those in the control group (all P<0.001). Conclusions KMC during cesarean section can improve the body temperature of late premature infants in the "golden hour", reduce the occurrence of hypothermia, facilitate early initiation of breastfeeding and improve the satisfaction of doctors and patients on health care.

Objective To explore the effects of early essential newborn care (EENC) on short-term maternal and neonatal health and to evaluate the satisfaction and acceptability of both patients and medical staff in the operating room regarding the implementation of EENC during term cesarean section(CS). Methods Two hundred gravidas who underwent CS in Wenzhou Medical University Affiliated Women and Children Hospital from January 2018 to April 2018 were recruited in this prospective study. According to the odd or even number of their medical records, these women were randomly divided into EENC or control group, 100 in each. EENC was offered to those in the EENC group immediately after birth, including drying the newborn immediately and thoroughly, mother–infant skin-to-skin contact at least 90 min and initiating the first breastfeeding, and delayed cord clamping until l-3 min after birth. Routine neonatal care was provided to the control group, including regular drying, insufficient skin-to-skin contact and cord clamping within 1 min after birth. Differences were compared between the two groups in the incidence of abnormal pulse, low oxygen saturation, hypothermia and mild asphyxia from the neonatal aspect and the incidence of postpartum hemorrhage and early initiation of breastfeeding from the maternal aspect. The acceptability and satisfaction of all the participants and the medical staff were also analyzed. t-test and Chi-square test were used as statistical methods. Results All of the 200 participants were finally analyzed. In the EENC group, the incidence of neonatal hypothermia [2% (2/100) vs 13% (13/100), χ2=8.721, P=0.003] and maternal postpartum hemorrhage [1% (1/100) vs 6% (6/100), χ2=5.701, P=0.035] were lower comparing to the control group, while the initiation rate of early breastfeeding was higher [56% (56/100) vs 5% (5/100), χ2=61.352, P<0.001]. There was no significant difference in the incidence of neonatal abnormal pulse, low oxygen saturation or mild asphyxia between the two groups (all P>0.05). The scores of maternal satisfaction (24.6±0.4 vs 23.4±1.9, t=6.443, P=0.001) and acceptability (24.3±0.5 vs 23.5±1.4, t=5.436, P=0.001) in the EENC group were also significantly higher than those in the control. For the obstetric operation team, the acceptability scores among obstetricians (22.6±0.8 vs 21.6±1.3, t=2.379, P=0.019), instrument nurses (23.2±0.9 vs 21.3±1.1, t=13.592, P<0.001) and anesthetists (22.6±0.9 vs 21.5±1.7, t=5.625, P=0.001) in the EENC group were higher than those in the control group. However, no significant difference was observed in the acceptability among rounding nurses between the two groups (P=0.086). Conclusions EENC during CS could stabilize the neonatal temperature, reduce postpartum hemorrhage, promote early breastfeeding and improve the maternal satisfaction as well as the acceptability of both obstetric operation team and puerperae. There is a clinical significance to promote EENC during CS.

The pre-hospitalization service is an important initiative for medical institutions to implement the national reform of the medical security system. In 2018, Zhejiang province proposed the " most run once reform", requiring the establishment of an admission preparation center to carry out pre-hospitalization services. In June 2021, a certain maternal and child health hospital conducted a process reengineering for the pre admission process of the admission preparation center by applying the combined process analysis and failure mode and effects analysis, high-risk points of the hospitalization process were screened, the job value and job functions of each sector were sorted out, and the sector for improvement sector was evaluated, to launch an independent information system, establish a one click automatic import of pre hospital medical orders function, and remove on-site billing physicians from various specialties for improvement measures. The steps of the process had been optimized, inlcuding issuing pre hospital medical orders, waiting for pre-hospitalization, pre-hospitalization, and so on. The completeness rate of pre hospital medical orders, average waiting days before hospitalization, and patient satisfaction scores of pre hospitalization centers had changed from 91%, 2.99 days, and 93.46 points before process reengineering to 92%, 2.44 days, and 95.80 points after reengineering, respectively. This practice had achieved dual improvements in pre admission service quality and efficiency, so as to provide a reference for China′s medical institutions to carry out safe and efficient pre admission services.