OBJECTIVE:To establish a HPLC method for content determination of salvianolic acid B and chrysophenine glycoside in Xiaozhiyin.METHODS:The compounds were base-isolated on the column of Kromesile C 18 at30℃and gradient elution was performed in mobile phase of acetonitrile-0.15%phosphoric acid solution,the wavelength was320nm,and the flow rate was1ml/min.RESULTS:The linearity was obtained between sample size and peak area score over the range of0.8336?g～ 8.336?g(r=1.0000)for salvianolic acid B,and0.352?g～3.52?g(r=1.0000)for chrysophenine glycoside.The average re?covery rate was99.5%(RSD=0.40%)for salvianolic acid B and100.2%(RSD=0.70%)for chrysophenine glycoside.CON?CLUSION:The method is accurate,simple,and highly reproducible,and it can be used for the quality control of Xiaozhiyin.

Objective:To evaluate the diagnostic value of rifampin resistance real-time fluorescent quantitative nucleic acid amplification technology (GeneXpert) combined with T cell spot test of tuberculosis infection (T-SPOT.TB) in tuberculous meningitis (TBM).Methods:The clinical data of 70 TBM patients (TBM group) and 30 non-TBM patients (non-TBM group) in Shenyang Chest Hospital from March 2017 to December 2019 were retrospectively analyzed. All patients were detected by GeneXpert and T-SPOT.TB. The results of MGIT960 liquid culture of cerebrospinal fluid were used as the gold standard to evaluate the diagnosis of TBM by GeneXpert and T-SPOT.TB.Results:The positive rates of GeneXpert and T-SPOT.TB in parallel and in series in TBM group were significantly higher than those in non-TBM group: 27.14% (19/70) vs. 0, 72.86% (51/70) vs. 46.67% (14/30), 78.57% (55/70) vs. 46.67% (14/30) and 21.43% (15/70) vs. 0, and there were statistical differences ( P<0.01 or <0.05). The sensitivity and accuracy of two methods in parallel in TBM diagnosis were 78.57% and 71.00% respectively. The specificity and misdiagnosis rate of two methods in series in TBM diagnosis were 100.00% and 0 respectively. Conclusions:The sensitivity of GeneXpert and T-SPOT.TB in parallel is the highest in TBM diagnosis. The specificity of the two methods in series and GeneXpert alone is as high as 100.00%. The two methods can reduce the misdiagnosis rate of TBM in series and reduce the rate of missed diagnosis in parallel.

OBJECTIVE To assess the superiority of new type bi-level positive airway pressure(Bi-PAP) in treating overlap syndrome. METHODS Sixteen cases diagnosed overlap syndrome were quickly given Bi-PAP treatment simultaneously,where their therapeutic efficacy of antibiotic,relieving spasm,diuresis and respiratory stimulant in advance was not fine.All patients were divided into new type Bi-PAP and old Bi-PAP groups based on the type of machines used. RESULTS Seven of 16 patients receiving new type Bi-PAP got remission through non-invasive mechanical ventilation.Among the other 9 patients receiving old type Bi-PAP,6 got remission through non-invasive mechanical ventilation,3 received invasive mechanical ventilation because of poor response to non-invasive mechanical ventilation. CONCLUSIONS More acute overlap syndrome patients can get remission through new type Bi-PAP without invasive mechanical ventilation and have decreased possibility of getting hospital-acquired pneumonia.

Objective:To explore the real return-to-work experiences and expectations of young and middle-aged stroke patients in community, in order to provide reference for the formulation of the support plan for returning to work from the perspective of patients, and further promote their return to work.Methods:Using the phenomenological method of qualitative research, 11 young and middle-aged stroke patients in Zhengzhou community from April to May, 2019 were interviewed in a semi-structured way, then the interview data were analyzed and the theme was extracted.Results:The community young and middle-aged stroke patients return-to-work experiences and expectations included the following five themes: uncertain return-to-work belief, limited work-related ability, complex inner feelings in the process of returning to work, insufficient external support and expectation of returning to work after stroke (The desire to return-to-work, expectation to get support and help related to returning to work).Conclusions:In order to promote young and middle-aged stroke patients in community to return to work, the three-way interaction mode of community-society-workplace should be considered from the aspects of patients' personal and external support to help patients recover actively, establish beliefs, reduce negative emotions, and further promote patients to return to work.

Objective To understand the condition of anxiety and analyze the influencing factors related to anxiety among nurses working in department of infectious diseases.Methods 206 nurses from 6 third class hospitals in Wenzhou were selected by simple random sampling method.A survey was carried out by using the socio-demo-graphic information questionnaire,working conditions questionnaire,self-rating anxiety scale and social support rating scale.Results The SAS score among nurses ranged from 36 to 72 points,and the average score was (48.32 ± 12.06)points,which was higher than the norm SAS value(t=14.39,P<0.01).The percentage of anxiety was about 55.33%.The percentage of moderate and severe anxiety was 16.51%.The main factors related to the anxiety among nurses were age(t=11.34,P<0.01),working years(t=5.68,P<0.01),moonlit night shift(t=4.42,P<0.05), worrying about making mistakes(t=7.18,P<0.01),worrying about occupational exposure(t=19.93,P<0.01) and nursing management of much criticism(t=5.68,P<0.01).Conclusion The condition of anxiety was serious among nurses working in department of infectious diseases.Interventions should be taken to reduce the anxiety level among nurses.

OBJECTIVE:To establish a method for the content determination of zolpidem tartrate in microsamples of rat plas-ma. METHODS:Rats were given zolpidem tartrate solution 3 mg/kg intragastrically,and 0.2 ml blood sample were collected and isolated. 50 μl plasma was precipitated by methanol,and the supernatant was determined by HPLC-fluorescence combined with ex-ternal method. Agilent HC-C18 column was used with mobile phase consisted of 0.03 mol/L KH2PO4 solution(containing 0.2% tri-ethylamine)-methanol (33∶67,V/V) at flow rate of 1.0 ml/min. The excitation and emission wavelengths were 254 nm and 390 nm,respectively. The sample size was 20 μl. RESULTS:The linear ranges of zolpidem tartrate in plasma was 2-200 μg/L(r=0.999 7),and the limit of quantification was 2 μg/L. The method recoveries of zolpidem were (96.96 ± 1.35)%-(105.0 ± 5.36)%(RSD=2.20%-4.88%,n=5),and extraction recoveries were (79.72 ± 0.01)%-(80.77 ± 0.02)%(RSD=1.34%-3.90%,n=5). The intra-day and inter-day RSDs were 1.40%-5.10% and 3.22%-9.25%(n=5),respectively. CONCLUSIONS:The method is simple,sensitive and suitable for the content determination of zolpidem tartrate in microsamples of plasma.

Discipline development is the core power of hospital development,which is highly emphasized by Beijing Municipal Administration of Hospitals.To meet the demands of public hospitals reform and requirements of municipal hospitals development,performance evaluation is used as a tool for municipal hospitals in their fine management.This paper introduced the research performance evaluation system and index design of Beijing’s municipal hospitals,with a summary and analysis the operating and practices.

BACKGROUND: Adipose tissue-derived mesenchymal stem cells (ADMSCs) have the multilineage differentiation potential, and are relatively easier to be obtained, thus they have attracted more and more attention as a new seed cell for cell engineering.OBJECTIVE: To observe the in vitro culture conditions of ADMSCs isolated from rat's subcutaneous adipose tissue, and identify them using immunohistochemical staining.DESIGN: An animal experiment.SETTING; Department of Cardiology, the General Hospital of Chinese PLA.MATERIALS: One healthy male Wistar rat of clean degree, 4 months old, weighing 200 g, was used. DMEM, fetal bovine serum were from GIBCO; Monoclone antibodies of rabbit-anti-rat CD13, CD34, CD44, CD45, CD105, D-related human leucocyte antigen (HLA-DR), factor-Ⅷ, vov Willebrand factor (VWF), Myosin, SABC kits and DAB staining kit from Wuhan Booster Biological Engineering, Co.,Ltd; Adeno-associated virus encoding green fluorescent protein from Vector Gene Technology Company Limited (Beijing).METHODS: The experiments were carried out in the Department of Internal Medicine, the General Hospital of Chinese PLA in October 2006. ① Cell isolation and culture: 0.3 g adipose tissue was cut from subcutaneous adipose tissue of Wistar rat's groin under aseptic condition, then minced and digested before culture, DMEM was changed at 2-3 days after plenty of fusiform-shap ed attached cells were observed under microscope, and the cell growth was observed. The cell concentration was adjusted to 2×107 L-1, then seeded into 96-well plate, and 100 μL for each well. From the second day, 3 wells were randomly selected every day, the cells were released with tripsin, and counted with blood cell counting chamber under inverted microscope. ② Cell viability assay: ADMSCs of passages 3 to 8 were added to DMSO freeze medium, and thawed after 2-4 weeks, and the cell viability was assessed by trypan blue dye exclusion. ③Immunohistochemical staining and identification: 2 ×107 L -1 cells were seeded to culture plate, then the immunohistochemical (SABC method) identification and Oil red O staining were performed to determine the cell surface antibodies of CD13, CD34, CD44, CD45, CD105, HLA-DR, factor-Ⅷ, HLA-DR and VWF. ④Lineage-specific differentiation and identification: The ADMSCs were plated on multi-well chamber and induced with lineage-specific media supplementation at least two weeks and identified by histologic/immunohistochemical assay of Oil red O for adipogenisis, alkaline phosphatase (ALP) stain for osteogenisis and Myosin monoclonal antibody for myogenisis. ⑤Transfected adenovirus carried green fluorescence protein (AD-GFP) medium: The fourth generation of ADMSCs were seeded on 96-well plate, 3 000 cells for each well, serum-free DMEM was changed after 24 hours, and added by AD-GFP at the same time, then transfected with different multiplicity of infection (MOI) of 1∶50, 1∶100, 1∶150 and 1∶200respectively, and then the transfection was observed.MAIN OUTCOME MEASURES: ① Results of cell isolation and culture; ② Cell viability after freezing and thawing; ③Results of immunohistochemical staining and identification; ④ Results of lineage-specific differentiation and identification;⑤ Results of transfected adenovirus carried AD-GFP.RESULTS: ① About 3.6×105 attached cells were obtained from 0.3 g subcutaneous adipose tissue, and these cells could be subcultured for passages in vitro with stable population doubling time. ② The cells were thawed after freezing for 2-3 weeks, and the trypan blue staining showed that the cell viability was above 90%. ③ The immunocytochemical staining showed that CD13, CD44, CD105 were positive and CD45, factor-Ⅷ, HLA-DR and VWF negative in different generations. ④ From the second generation, a few Oil red O positively stained cells were observed, which were obviously increased after prolonging the refreshing. After lineage-specific differentiation, the cells were all positive by Oil red O staining, ALP staining and Myosin immunohistochemical staining. ⑤ 72 hours after transfection, it was observed under fluorescence microscope that most cells were green fluorescence when the MOI value was 1∶200, the transfection was successful, and it was generally determined that the transfection rate was above 90%.CONCLUSION: A large number of ADMSCs with multilineage differentiation potential can be easily obtained from rat adipose tissue, osteoblast, myoblasts, they can be expanded in large quantity and stored in vitro for long time, AD-GFP were also successfully transfected.

Objective To analyse the adherence of community-dwelling stroke survivors to functional exercise regimens and explore the influencing factors.Then to establish measures to improve the situation.Methods A total of 208 stroke survivors from 10 communities were randomly recruited.Four questionnaires-a general information questionnaire,an exercise adherence questionnaire,a self-efficacy perceptions scale and a perceived social support scale-were administered.Results The mean adherence score was 34.71 ± 8.45 and the mean adherence rate was 61.98％.The compliance to physical exercise,seeking advice positively and exercise effectiveness monitoring scores ranged from highest to lowest in order.Self-efficacy perceptions and perceived social support were both positively correlated with the adherence rate.Multiple linear regression showed that the influencing factors included self efficacy perceptions,social support perceptions,self-care ability and age.Conclusions The community stroke survivors' exercise adherence was moderate in general,but it could be improved by increasing their self-efficacy and social support perceptions and their self-care ability.

Objective:To compare the dosimetric difference between knowledge-based planning (KBP) volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) models for predicting the dose distribution during IMRT, aiming to investigate the feasibility of VMAT model to predict the IMRT plans.Methods:Fifty prostate cancer patients who had completed radiotherapy were selected. Manual planning was performed on each selected patient to generate the corresponding IMRT and VMAT plans. The IMRT and VMAT manual plans of the 40 randomly-selected patients were adopted to generate the KBP VMAT and IMRT models. The remaining 10 patients were utilized to predict IMRT plans. VMAT library-derived IMRT model (V-IMRT) and IMRT library-derived IMRT model (I-IMRT) were generated. Dosimetric parameters related to organ-at-risks (OARs) and planning target volume (PTV) were statistically compared among the manual IMRT (mIMRT), V-IMRT and I-IMRT plans.Results:Compared with the mIMRT plan, I-IMRT could significantly better control D max of the PTV ( P=0.039), whereas V-IMRT and I-IMRT plans could better protect the bladder and bilateral femoral heads (both P<0.05). V-IMRT plan could better protect the D max of bilateral femoral heads and the D 15% of the right femoral head (both P<0.05), whereas no significant difference was observed in other OARs and PTV (all P>0.05). Conclusions:Compared with the manual plans, KBP IMRT plan has significant advantages in protecting the OARs. KBP VMAT and IMRT models are both feasible in clinical practice, which yield equivalent accuracy for predicting IMRT plan.