Objective To observe the clinical efficacy of Peng’s eye acupuncture in treating headache.Method Sixty headache patients were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by Peng’s eye acupuncture (acupuncture at ocular points after syndrome differentiation), while the control group was by Chinese medication. The clinical efficacies were compared after a treatment course.Result The total effective rate was 93.3% in the treatment group versus 83.3% in the control group, and the difference was statistically significant (P<0.05).Conclusion Peng’s eye acupuncture is an effective method in treating headache.

BACKGROUND:Polyvinyl alcohol (PVA) hydrogel with similar porous structure and mechanical properties to the natural cartilage is very suitable for the repair of articular cartilage. However, the pure PVA hydrogel after lyophilization wil be accompanied by the shrinkage of the polymer network and the col apse of the pores, leading to the inhomogeneous performance of the material even in the state of re-swel ing. Addition of the active polymer wil increase the cel adhesion ability of PVA hydrogel. OBJECTIVE:To construct PVA/lota-carrageenan (l-CA) composite materials with different mass fractions of l-CA and evaluate the biocompatibility with vascular endothelial cel s. METHODS:PVA/l-CA composite films with different contents of l-CA were fabricated and then co-cultured with vascular endothelial cel s. Attachment, proliferation and morphological changes of vascular endothelial cel s on the composite were observed by scanning electron microscope and MTT assay to evaluate its biocompatibility. PVA/l-CA three-dimensional scaffold with different contents of l-CA were constructed, and hemolysis experiment was conducted according to the biological evaluation standards of medical devices, and the porosity and pore size were observed using scanning electron microscope. RESULTS AND CONCLUSION:In vitro experimental results showed that the addition of l-CA could significantly increase the biological activity of PVA hydrogel, and promote the cel attachment and proliferation on the scaffold. The hemolysis rate of each experimental group was less than 5%(the accepted safety standard), suggesting that the composite materials were in accordance with the standard of medical devices for hemolysis experiment. These findings indicate that the composite scaffolds with 20%-30%l-CA possess the pore size suitable for cel growth and proliferation and the porosity beneficial for transportation of nutrients and metabolites, which can serve as an excel ent scaffold for tissue engineering.

Ten compounds were isolated from the 95% ethanol extract of the stem bark of Toona sinensis by silica gel, ODS Sephadex LH-20 column chromatographies and preparation TLC methods. Their structures were elucidated by spectroscopic methods and chemical properties as betulinic acid(1), stigmastane-3, 6-dione(2), stigmast-4-en-3-one(3), 7β-hydroxysitosterol(4), 6-hydroxystigmast-4-en-3-one(5), stigmast-4-ene-3β, 6β-diol(6), ergosterol peroxide(7), 7-methoxy-2-(3, 4-methylenedioxyphenyl)benzofuran-5-carboxylate(8), canthin-6-one(9), and α-acetylamino-phenylpropyl α-benzoylamino phenylpropionate(10). All compounds were isolated from T. sinensis for the first time.

Dermatomyofibroma is a benign and rare proliferation of myofibroblasts and fibroblasts of the skin.Dermatomyofibroma commonly locates at the shoulder and neck of young adults and adolescents.Other frequently affected anatomic sites are upper arms,thigh,chest wall,back,axillary region and abdomen.Herein,we reported a case of dermatomyofibroma occurred in the nasion.The asymptomatic firm nodule and histopathological features were consistent with dermatomyofibroma.Immunohistochemically,the tumor cells expressed vimentin,HHF35 and α-smooth muscle actin (α-SMA).The patient was followed up for 2 years after excision of the tumors and recurrences were not observed.

Objective:To evaluate the optimized effect of erector spinae plane block (ESPB) combined with general anesthesia when used for the patients undergoing laparoscopic pancreaticoduodenectomy.Methods:Sixty-eight American Society of Anesthesiologists physical status Ⅱ orⅢ patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, scheduled for elective laparoscopic pancreaticoduodenectomy, were divided into general anesthesia group (group G, n=34) and ESPB combined with general anesthesia group (group EG, n=34) using a random number table method.In group E, ultrasound-guided ESPB was performed before induction with general anesthesia, and 0.375% ropivacaine 20 ml was injected into both sides.Total intravenous anesthesia was applied in both groups.Patient-controlled intravenous analgesia (PCIA) with sufentanil 1.5 g/kg in 100 ml of normal saline was performed after surgery.The PCIA pump was set up to deliver a 2 ml bolus dose with a 5-min lockout interval and background infusion at 3 ml/h.Analgesia was performed until 24 h after operation, and the visual analogue scale score at rest was maintained at ≤4.Sufentanil 0.1 g/kg was intravenously injected as rescue analgesic when visual analogue scale score >4.The extubation time and occurrence of intraoperative cardiovascular events were recorded.The amount of sufentanil used during operation and within 24 h after operation was recorded.The time to first pressing the analgesia pump after operation and effective pressing times of PCA within 24 h after operation were recorded.Time to first flatus, first ambulation time and length of postoperative hospital stay were recorded.The development of postoperative adverse reactions such as nausea and vomiting, irritability and respiratory depression within 24 h after operation was recorded. Results:Compared with group G, the incidence of intraoperative hypertension and tachycardia was significantly decreased, the extubation time was shortened, the consumption of sufentanil during operation and within 24 h after operation was reduced, the time to first pressing the analgesia pump was prolonged, the effective pressing times of PCA within 24 h after operation were reduced, time to first flatus, first ambulation time and length of postoperative hospital stay were shortened, and the incidence of nausea and vomiting, irritability and respiratory depression within 24 h after operation was decreased in group EG ( P<0.05). Conclusion:The combination of ESPB and general anesthesia is helpful in achieving an anesthesia mode of lower opioid consumption and more helpful for inhibition of postoperative pain responses and for early postoperative recovery than general anesthesia alone when used for the patients undergoing laparoscopic pancreaticoduodenectomy.

Objective:To analyze the salary level, change trend and salary satisfaction of nurses in tertiary public hospitals in China.Methods:The data was derived from three round third-party evaluation of the China Healthcare Improvement Initiative at 136 tertiary public hospitals from December 2017 to January 2018, March 2019 and January to March 2021. The self-reported salary, expected salary and salary satisfaction rate of nurses were analyzed.Results:The sample sizes of the three evaluations were 27 575, 27 568 and 25 197, representing the salary situation in 2017, 2018 and 2020 respectively. In 2017, 2018 and 2020, the actual average annual salary of nurses was 81 600 yuan, 100 000 yuan and 110 000 yuan respectively, the expected average annual salary was 140 000 yuan, 160 000 yuan and 160 000 yuan respectively, and the ratio of expected salary to actual salary was 1.72, 1.60 and 1.45 respectively. In 2017, 2018 and 2020, the proportion of nurses satisfied with their current income was 34.0%, 33.7% and 43.6% respectively. In 2020, nurses in the eastern region, other specialized hospitals, senior professional titles and graduate degrees had highest annual salary.Conclusions:The salary level and satisfaction rate of nurses in tertiary public hospitals in China show a slow growth trend, and the gap between actual salary and expected salary is gradually narrowing.

OBJECTIVETo explore an optimum method on postoperative recovery of general-anesthesia gynecological laparoscopic surgery.

METHODSOne hundred and twenty cases of gynecological laparoscopic surgery were randomly divided into three groups, 40 cases in each one. The sensitive points of bilateral Shenmen (TF4), Zigong (TF2), Wei (CO4), Dachang (CO7) and so on were selected in all three groups one night before the surgery. The sticking with magnetic beads was applied in the group A. The magnetic beads were in-pair stuck at front-back corresponding location of both ears in the group B. The same-appearance plaster was put at the corresponding acupoints in the group C. The intubation anesthesia was applied in all three groups and postoperative recovery of gynecological laparoscopic surgery was observed.

RESULTSThe postoperative visual analogue scale (VAS) was (1.77 +/- 1.65) in the group A and (1.80 +/- 1.96) in the group B, which was both lower than (2.62 +/- 1.46) in the group C (both P < 0.01). The occurrence rate of nausea and vomiting was 25.0% (9/36) in the group A and 20.0% (8/40) in the group B, which was both lower than 50.0% (19/38) in the group C (both P < 0.01). The recovery of borborygmus on postoperative 1st and 3rd day in the group A and B was faster than that in the group C (both P < 0.05), while time of fart and defecation in the group A and B was earlier than that in the group C (both P < 0.05). The score of state-trait anxiety inventory in the group A and B was lower than that in the group C (both P < 0.05), but the differences of each item between the group A and B were not obvious (both P > 0.05).

CONCLUSIONThe auricular point sticking could support analgesia of general-anesthesia gynecological laparoscopic surgery, which could relieve anxiety mood, reduce occurrence of nausea and vomiting and improve function of stomach and intestine to benefit postoperative recovery. However, the effect of in-pair sticking of auricular point with magnetic beads at front-back acupoints was not obviously strengthened.

Acupuncture, Ear ; Adult ; Aged ; Female ; Humans ; Laparoscopy ; Middle Aged ; Postoperative Nausea and Vomiting ; therapy ; Young Adult

Objective:To analyze the current level and dynamic change of the salary and income satisfaction rate of doctors in Chinese tertiary public hospitals in recent years.Methods:In January 2018, March 2019 and March 2021, the project team of " the third party evaluation of the China Healthcare Improvement Initiative" conducted a questionnaire survey among doctors of 136 tertiary public hospitals in 31 provinces. The first-line clinicians were investigated by stratified sampling method. The salary level and satisfaction of doctors were investigated by questionnaire. Chi square test was used for comparison between groups.Results:The sample size of the three surveys was 20 786, 23 289 and 22 836 respectively. The median value of doctors′ actual income after tax in 2017, 2018 and 2020 was 100 800 yuan, 120 000 yuan, 150 000 yuan respectively, and the median expected annual income after tax was 196 000 yuan, 250 000 yuan and 250 000 yuan. The proportion of doctors satisfied with the current income was 16.5%, 17.8% and 26.9% respectively. The salary and satisfaction rate of doctors had an upward trend, but the overall level was still low.Conclusions:In recent years, the salary of doctors in tertiary public hospitals in China has been improved to a certain extent, but on the whole, it is at a low level, and there is still much room for improvement. In the future, the government needs to improve the hospital salary system and increase the salary of doctors continuously, especially needs to pay attention to the doctors with high education level and intermediate titles.

Objective:To understand the changes in the practice environment from the perspective of doctors in 136 tertiary public hospitals, and to provide evidence for formulating strategies and measures to improve the practice environment of doctors.Methods:The data was collected from five rounds of China Healthcare Improvement Evaluation Survey from December 2015 to March 2021. The sample size was 17 945, 19 774, 20 786, 23 289, and 22 836, with a total of 104 630. The self-designed questionnaire on four dimensions of doctor-patient relationship, workload, administrative logistics support and professional identity was performed.Results:From the 1st to the 5th survey, the approval ratio of " the administrative and logistics department of this hospital is highly efficient" showed the characteristics of " U-shaped distribution" , and the approval ratio of " approve or encourage children to continue to engage in medical work" increased from 13.38% to 23.91%.From the 2nd to the 5th survey, the percentage of doctors who experienced doctor-patient disputes dropped from 28.96% to 23.20%, and the percentage of doctors agreeing that the relationship between doctors and patients in this hospital was improving continued to increase from 33.20% to 60.45%.From the 3rd to the 5th survey, the proportion of doctors experiencing medical troubles dropped from 15.10% to 14.19%, and the recognition rate of " the cafeteria of this hospital provided medical staff with nutritious and delicious meals" increased from 36.25% to 47.52%, and the approval proportion of " my current work load is heavy" dropped from 61.55% to 45.24%. The results of the 5th survey showed that there were significant differences in the approval ratios of each dimension in different genders, job titles and hospital types( P<0.001). Conclusions:From the perspective of doctor-patient relationship, workload, administrative logistics support, and professional identity, the improvement of doctors′ practice environment is still insufficient. Hospital administrators should continue to focus on the improvement of the doctor-patient relationship, and take necessary measures to reduce doctors′ workload and improve doctors′ professional identity.

We studied structural and immunological properties of the SARS-CoV M (membrane) protein, based on comparative analyses of sequence features, phylogenetic investigation, and experimental results. The M protein is predicted to contain a triple-spanning transmembrane (TM) region, a single N-glycosylation site near its N-terminus that is in the exterior of the virion, and a long C-terminal region in the interior. The M protein harbors a higher substitution rate (0.6% correlated to its size) among viral open reading frames (ORFs) from published data. The four substitutions detected in the M protein, which cause non-synonymous changes, can be classified into three types. One of them results in changes of pI (isoelectric point) and charge, affecting antigenicity. The second changes hydrophobicity of the TM region, and the third one relates to hydrophilicity of the interior structure. Phylogenetic tree building based on the variations of the M protein appears to support the non-human origin of SARS-CoV. To investigate its immunogenicity, we synthesized eight oligopeptides covering 69.2% of the entire ORF and screened them by using ELISA (enzyme-linked immunosorbent assay) with sera from SARS patients. The results confirmed our predictions on antigenic sites.
Amino Acid Sequence ; Base Sequence ; Cluster Analysis ; Enzyme-Linked Immunosorbent Assay ; Immunoassay ; Molecular Sequence Data ; Mutation ; genetics ; Oligopeptides ; Phylogeny ; Protein Structure, Tertiary ; SARS Virus ; genetics ; Sequence Alignment ; Sequence Analysis, DNA ; Viral Matrix Proteins ; chemistry ; genetics ; immunology