TCM gel paste is a new transdermal medicine delivery system, with a lot of advantages, which has been widely used in clinic. By searching domestic research literature about TCM gel paste in recent years, this article reviewed from patent overview, matrix, transdermal absorption enhancer, preparation technology, quality evaluation, clinical efficacy and safety, problems and prospects, with a purpose to provide references for clinical medication of TCM gel paste.

Objective To analyze the influence of radial neck fracture on the upper limb function in older children,and to evaluate the curative effect of plate fixation in the treatment of Salter-Harris Ⅱ type of radial neck fracture.Methods The clinical data of 16 older children with radial neck fractures who treated by T plate internal fixation were retrospectively analyzed.16 cases were closed fractures,merging radial nerve injury in 1 case,3 cases of distal humerus fractures,1 case with rib fractures,fractures were Salter-Harris Ⅱ type,adopt steel plate internal fixa tion.Results 1 6 patients were followed up for 9-1 8 months.X-ray healing time was 6-9 weekson average 7.6 weeks.No malunion and no healing,no case of epiphyseal injuries.1 patient appeared steel block forearm supination.Postoperative patients with forearm pronation were greater than 90° supination were greater than 60 °.No radial nerve injury.Evaluation results were good.Conclusion Clinical treatment effect of open reduction and plate internal fixation in the treatment of older children with Salter-Harris Ⅱ type of radial neck fracture is satisfactory.Surgical treatment not only can enhance the fracture stability,but also can do the elbow joint function exercise to prevent dysfunction much earlier.

Objective To explore the effects of pigmentary epithelium derived factor (PDEF) on the phenotypic and immunologic function of murine-derived dentritic cells(BMDCs) .Methods Mononuclear cells(MNCs) isolated from murine bone marrow were cultured in RPMI1640 medium containing rmGM-CSF and rmIL-4 for 5 d ,and were divided into five groups .MNCs were stimulated for 3 d with either 50 ,100 ,200ng/mL PEDF ,1 μg/mL LPS(positive control) or RPMI1640(negative control) .The expression of CD11c ,CD80 and CD86 on DCs surface were analyzed by the fluorescence activated cell sorting (FCM ) .The ability of PEDF-induced BMDCs to stimulated T cell maturation were determined by the CCK-8 method and the level of IL-12 in the culture supernatant was detected by ELISA .Results The PEDF-treated BMDCs expressed high levels of CD11c ,CD80 and CD86 ,enhanced the immunolog-ical activities of T lymphocyte and its secretion of IL-12 when compared with untreated DCs .Conclusion PEDF can significantly up-regulate the expression of DCs immunological labelled molecule in in vitro cultured murine and increase its immunological com-petence .

Objective To evaluate wall histological abnormalities 2 to 3 cm to the end in high or intermediate anal atresia in order to identify features that explain postoperative bowel dysfunctions.Methods Sixty anal atresia patients treated in the Capital Pediatric Institution between January 2008 and December 2012 were recruited in our study.36 patients were resected the terminal anal segment (3 cm).Compared with those 24 cases who were not.Resected samples were fixed for HE and immuno-histochemical stainings.Clinical data including sacral ratio (SR),age at operation,gender,bowel function were evaluated.Results There was no significant difference in patients' SR value,gender and age at operation between resected group and control group.The median follow-up period was 4.5 years.The rates of voluntary bowel movement,soiling (grade 1,2,3) were similar in both groups,however,the rates of severe constipation in resection group was significantly lower that in control group (3 ％ vs.21％,P ＜ 0.05) In the bowel wall of distal 2 cm anrectal canal,the connective tissue was found to be irregular and abnormally represented.Muscle coat was abnormal in all cases,showing the dysplasia circular and longitudinal layers.The number of enteric nervous system was significant fewer in distal 2cm anrectal canal than that in distal 3 cm(1.6 ±0.9 vs.5.6 ±1.8,t=11.715,P＜0.01).Conclusions Resection of terminal 3 cm at least of the atresia anal canal benefits postoperative bowel defecation function.

Activity of IL-1 produced by peripheral blood monocytes stimulated with lipopolysaccharide in vitro was detected from 17 acute cases, 14 chronic cases and 19 advanced cases of schistosomiasis japonica. It was found that the level of IL-1 was significantly increased and positively related to the body tempereture in the group with acute schistosomiasis. The activity of IL-1 was statistically reduced in the chronic and advanced groups, especially in the latter. After inhibiting the synthesis of prostaglandin with indomethacin, the level of IL-1 was significantly increased in three groups of patients, but no apparent change in the normal contro group. The results indicate that IL-1 may play an important role in inducing the inflammatory reaction in patients with acute schistosomiasis japonica and in the immunoregulation in the chronic stage. The changes of IL-1 activity in patients with schistosomiasis japonica may be closely related to prostaglandin.

Objective To apply intervention of integrated pharmaceutical care (IPC) for asthma-COPD overlap syn-drome patients,so as to reduce the side effects of drugs,enhance medication compliance,promote reasonable drug application,cut down the medical expenses in ACOS patients. Methods A total of 60 ACOS patients were randomly divided into IPC group (group A) (n=34) and contrast group(group B) (n=26).The patients in group A were given IPC measurements such as noso-comial guidance,classroom teaching,regular follow-up,life coaching and psychological advice.While the patients in group B were not given any intervention measures. Results In group A,patients' awareness rate of action and side-effects of drugs were ob-viously increased;Knowledges of inhalation preparation were greatly improved;the ratio of ADRs was significantly reduced;The FEV1 and the value added of FEV1 was dramatically improved.Furthermore,the differences showed statistical significance as com-pared with group B(P<0.05).Total medical costs and anti-bacterial drug costs per year were significantly lower in group A than group B. Conclusion IPC is beneficial to enhance drug compliance,promote reasonable drug application and bring down the medical expenses in ACOS patients.

Objective: To investigate the application value of cardiovascular magnetic resonance tissue-tracking (CMR-TT) in the quantitative assessment of global and segmental myocardial strain after myocardial infarction. Methods: From June 2013 to June 2017, 45 patients with chronic myocardial infarction from the Second Affiliated Hospital of Nanchang University and eighteen normal volunteers as a control group were included in our research. All participants received CMR examination on a 3.0 T MRI scanner. Imaging protocol including FIESTA cine sequence (left ventricle short-axis planes, four chamber and two chamber long-axis planes) and late gadolinium enhancement (LGE). CMR-TT was undertaken using cvi 42 dedicated commercial software, global peak systolic circumferential, longitudinal, radial strains (GPCS, GPLS, GPRS) and segmental peak systolic circumferential, longitudinal, radial strains (PCS, PLS, PRS) in accordance with the American Heart Association's sixteen segment model were all derived. All segments were divided into five groups according to transmural extent expressed as enhanced area per segment: 0% as non-LGE segments group, 1 %-25 % as mild LGE segments group, 26%-50 % as moderate LGE segments group, 51%-75% as severe LGE segments group and >75% as complete LGE segments group. Two-independent samples t-test and Kruskal-Wallis H test were used, respectively, to compare means of 2 and 3 or more groups of continuous variables. Variables with normal distribution were presented as ±s, non-normal variables were reported as median (interquartile range). Results: Patients showed significant lower GPRS, GPCS and GPLS than the control group (15.13%±8.18%, -8.25%±3.23%, -7.11%±2.41% versus 32.41%±12.99%, -14.92%±3.32%, -11.50%±2.51%). PRS, PCS and PLS statistically significantly decreased with increasing extent of myocardial enhancement (t=-6.35,7.33,6.44, P<0.001).Segmental peak systolic strains of five groups were:PRS:24.87% (10.95%,39.02%), 13.26%(5.94%,24.24)%, 9.47%(4.01%,18.40%), 5.98%(-3.74%,11.86%), -2.65%(-6.62%,8.59%), respectively; PCS: -11.84%±5.34%, -8.60%±5.48%, -7.32%±5.59%, -5.30%±5.52%, -2.74%±5.24%, respectively; PLS: -9.47%±6.82%, -7.72%±6.22%, -7.07%±6.49%, -5.55%±5.95%, -3.54%±5.44%, respectively. The differences in the groups were statistically significant (H=164.47,166.61, 59.06, P<0.001). GPRS was positively correlated with LVEF(r=0.543, P<0.001), while GPCS and GPLS were both negatively associated with LVEF (r=-0.654, P<0.001; r=-0.682, P<0.001, respectively). Conclusions CMR-TT can quantitatively assess the severity of myocardial infarction accurately and reliably.Strain parameters have a good correlation with cardiac function indexes, this may be helpful in the recognition of left ventricular remodel after MI.

This study aimed to investigate the efficacy and safety of apatinib plus programmed cell death protein 1 (PD-1) blockades for patients with metastatic colorectal cancer (CRC) who were refractory to the standard regimens. In this retrospective study, patients with metastatic CRC who received apatinib plus PD-1 blockades in clinical practice were included. The initial dosage of apatinib was 250 mg or 500 mg, and PD-1 blockades were comprised of camrelizumab, sintilimab and pembrolizumab. Efficacy and safety data were collected through the hospital’s electronic medical record system. From October 2018 to March 2022, a total of 43 patients with metastatic CRC were evaluated for efficacy and safety. The results showed an objective response rate of 25.6% (95% CI, 13.5%-41.2%) and a disease control rate of 72.1% (95% CI, 56.3%-84.7%). The median progression-free survival (PFS) of the cohort was 5.8 months (95% CI, 3.81-7.79), and the median overall survival (OS) was 10.3 months (95% CI, 5.75-14.85). The most common adverse reactions were fatigue (76.7%), hypertension (72.1%), diarrhea (62.8%), and hand-foot syndrome (51.2%).Multivariate Cox regression analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status and location of CRC (left or right-side) were independent factors to predict PFS of patients with metastatic CRC treated with the combination regimen. Consequently, the combination of apatinib and PD-1 blockades demonstrated potential efficacy and acceptable safety for patients with treatment-refractory metastatic CRC. This conclusion should be confirmed in prospective clinical trials subsequently.

Objective To investigate the current status of agitated behaviors among institutionalized elderly with dementia. Methods The Cohen-Mansfield Agitation Inventory (CMAI) and General Information questionnaire were used to collect information of agitated behaviors among 141 institutionalized elderly with dementia in a long-term care facility in Guangzhou. Results Nearly 90.07％(127/141) of the elderly with dementia had the symptoms of agitation. Among the four categories of the agitated behaviors, the incidence for physically non-aggressive behaviors (82.27％, 116/141) was the highest, followed by physically aggressive behaviors (78.72％ , 111/141), verbally non- aggressive behaviors (74.47％, 105/141) and verbally aggressive behaviors (64.54％, 91/141). Spitting, repetitive sentences or questions, complaining occurred frequently. Conclusions The incidence of the agitated behaviors was high and the manifestation and types of agitated behaviors were varied, which should be paid attention to by the institution. It is necessary to develop the personalized, systematic, standardized nursing intervention to provide the support for caregivers and help the elderly with dementia to cope with agitation.

OBJECTIVETo explore the feasibility and efficacy of laparoscopic surgery in the treatment of children with persistent cloaca.

METHODSClinical data of 26 female children with high type persistent cloaca undergoing operation in the Capital Pediatric Institution between November 2005 and February 2015 were retrospectively analyzed. Mean age of these children was (1.4±1.6) years old. Distal end of rectum locating in the superior border of pubis was the standard of diagnosis. Laparoscopy-assisted anorectoplasty (LAARP), vaginoplasty and urethroplasty were performed in 17 cases (LAARP group), including 3-port laparoscopy in 12 cases and single-port laparoscopy in 5 cases. Abdominoperineal pull through (APPT), vaginoplasty and urethroplasty were performed in the other 9 cases (APPT group). Sacral ratio (SR), length of common channel, intraoperative blood loss, operation time, postoperative hospital stay, postoperative complications and bowel function were compared between two groups. Postoperative defecation was evaluated by the Krickenbeck standard.

RESULTSOperations were successfully performed in all patients and no case in LAARP group was transferred to open abdominal operation. There were no significant differences in SR value, length of common channel and age at operation between the two groups. As compared to APPT group, the mean operative time was shorter [(124.1±4.9) minutes vs. (131.8±3.2) minutes, P=0.000], the intraoperative blood loss was less [(10.5±2.1) ml vs. (16.2±2.7) ml, P=0.000], and the postoperative hospital stay was shorter [(5.7±0.5) days vs. (9.2±0.4) days, P=0.000] in LAARP group. In LAARP group, there were no significant differences in operation time, intraoperative blood loss and postoperative hospital stay between 3-port and single-port laparoscopic surgery (all P>0.05). The mean follow-up period was (4.0±2.8) months in LAARP group and (6.0±2.3) months of APPT group. There is one case have wound infection in ARRT patients. The rates of voluntary bowel movement, soiling, constipation (grade 1, 2, 3) were similar in both groups, however, the overall bowel function after LAARP was better than that of ARRT according to the Krickenbeck classification (10.7±0.2 vs. 9.7±1.2, P=0.047). Postoperative rectal mucosa prolapse was found in 2 cases of LAARP group and 1 case in APPT group. One case of APPT group developed wound infection. No urethrovaginal fistula relapse, anal stenosis or urethral stricture was found in all the cases.

CONCLUSIONSThe LAARP is safe and feasible in the treatment of persistent cloaca.