Objective]To investigate academic thoughts of Prof. Yan Dexin in spleen and stomach syndrome treatment.[Methods]The paper summarized the academic origin, academic thoughts as well as practical treatment cases of Prof. Yan Dexin ’s spleen and stomach syndrome treatment theory. [Results]The main points of Prof. Yan’s academic thought on spleen and stomach therapy has succeeded and developed the therapy of Menghe physician, which includes an emphasis on spleen Qi rise and stomach Yin drop, Qi of spleen and stomach regulation, special attention on the function of the stomach-yang and spleen-yin, an advocation ofspleen leading four organs, and therapy design from spleen with an ingenious use of atractylodes rhizome, Atractylodes and Zhizhu pill. [Conclusion] Professor Yan Dexin developed his unique theoretical system in spleen-stomach diseases therapy on basis of the experiences of spleen and stomach disease treatment from ancient physicians, which is instructive for later physicians.

Objective To systematically review articles about therapeutic drug monitoring of vancomycin in Chinese adults, so as to provide a reference of vancomycin trough concentrations for clinical evidence-based medicine.Methods Literature concerning vancomycin therapeutic drug monitoring were electronically retrieved in, CBM, Wanfang data, CNKI and Vip.Furthermore, the articles written in English by Chinese author in PubMed, EMbase were included.All the data were searched from inception of the database or network to Aug.2014.Two reviews independently screened literature according to the inclusion and exclusion criteria, and assessed the quality of literature using the Combieg and NOS.Analyzing the types of studies, the number of therapeutic monitoring of vancomycin, trough serum concentration, clinical outcome and renal function.Results A total of 35 studies including 32 cross-sectional studies and 3 cohort studies were included, all studies were observational studies.3099 patients with 5206 blood concentrations monitoring results were eligible for final analyses in all 32 cross-sectional studies.The rates of trough serum concentration in 5-15 mg/L was 53.6%.Compared with the trough concentrations between 5 and 15 mg/L, clinical cure rate was no significant difference in the trough concentrations of over 15μg/mL.However, the incidence rate was significantly reduced in renal toxicity in 5-15 mg/L trough serum concentration.Conclusions For adults, trough serum concentration of vancomycin should adopt the 5-15 mg/L in China.However, considering lack of high-level evidence, so it needs to be studied further.

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

Objective To investigate the correlation between the transport time of preterm infants with respira-tory failure and the clinical outcome. And to determine the transit time in critically ill premature infants. Methods Premature infants in level Ⅱ neonatal ward in Hunan Province Children's Hospital from January 1 to December 31, 2013,admitted to the Neonatal Intensive Care Unit requiring respiratory support(invasive and noninvasive),were re-viewed. All the patients were classified into non - standardized transport group and regulate transport group according to respiratory support that infants in the level Ⅱ neonatal ward required. Data on general information,the time of ventilator application,the time of exposure to oxygen,morbidity of bronchopulmonary dysplasia(BPD),the cure and improvement rate,length of stay,the total length of stay(length of stay in the local hospital and our hospital),and hospitalization ex-penses were collected. Results Among the 363 infants,there were 107 cases in the non - standardized transport group, and 256 cases in the regulate transport group. The time of ventilator application in the non - standardized transport group was longer than that in regulate transport group[(19. 75 ± 19. 53)d vs(13. 02 ± 12. 64)d,t = 18. 706,P ﹤ 0. 05],the time of exposure to oxygen was longer[(30. 60 ±24. 80)d vs(19. 50 ±19. 24)d,t =6. 883,P ﹤0. 05],the morbidity of BPD was higher[57. 01%(61/ 107 cases)vs 18. 36%(47/ 256 cases),χ2 = 53. 934,P ﹤ 0. 05],but the cure and im-provement rate was lower[70. 10%(75/ 107 cases)vs 83. 20%(213/ 256 cases),χ2 = 7. 912,P ﹤ 0. 05],and the total length of stay was longer[(59. 50 ± 34. 02)d vs(34. 48 ± 23. 69)d,t = 22. 967,P ﹤ 0. 05]than that in the regulate group. But there was no significant difference between the length of stay[(43. 99 ±28. 08)d vs(32. 79 ± 23. 76)d,t =2. 012,P ﹥0. 05]in the non - standardized transport group and regulate transport group,with the hospitalization expenses [(6. 55 ±4. 30)vs(4. 99 ±4. 12)thousands yuan,t =0. 552,P ﹥0. 05]. Conclusions The non - standardized transport group has higher morbidity of BPD,but lower cure or improvement rate,and it has longer length of stay. The 2013 edition of Chinese Neonatal Ward Hierarchical Construction and Management Guide(Proposal)is reasonable,level Ⅱ neonatal ward should be in strict accordance with it to transport regional neonatal.

ObjectiveTo investigate the composition and changing trend of the etiologies of liver failure in Shaanxi Province, China. MethodsA retrospective analysis was performed for the clinical data of 975 patients with liver failure who were hospitalized in The First Affiliated Hospital of Xi’an Jiaotong University from January 2008 to December 2017. According to the clinical type of liver failure, the patients were divided into acute liver failure (ALF) group with 115 patients, subacute liver failure (SALF) group with 165 patients, and acute-on-chronic liver failure (ACLF) group with 695 patients. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the t-test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. ResultsDrug was the primary cause of ALF (25.22%, 29/115), followed by hepatitis B virus (HBV) infection (21.74%, 25/115); HBV infection was the primary cause of SALF (35.15%, 58/165), followed by drug (27.27%, 45/165); HBV infection was the primary cause of ACLF (87.19%, 606/695), followed by alcohol (3.45%, 24/695). The main age distribution of patients with liver failure due to HBV infection, alcohol, and drug was 20-60 years (595/689), 30-40 years (22/32), and 30-70 years (67/89), respectively. There was a significant reduction in the proportion of patients with HBV-related liver failure in the recent 5 years (61.52% vs 81.33%, χ2=45.87, P＜0.001), while there were significant increases in the proportion of patients with drug-induced liver failure (13.14% vs 4.44%, χ2=22.10, P＜0.001) and alcoholic liver failure (4.76% vs 1.56%, χ2=7.85, P=0005). Further analysis showed that the age of onset of HBV-related liver failure in the recent 5 years was significantly higher than that in the first 5 years (45.3±13.0 vs 42.5±12.9, t=-2.567, P=0.011). ConclusionManagement of chronic HBV infection is still an important link in the control of liver failure, and meanwhile, the prevention and treatment of drug-induced and alcoholic liver diseases should be strengthened. More attention should be paid to the treatment of elderly patients with liver failure.

Objective:To investigate the application effects of nitrous oxide and oxygen mixed inhalation technology on analgesia and sedation during debridement and dressing change in children with moderate or severe burns.Methods:A retrospective non-randomized contemporary controlled study was conducted. From December 2019 to November 2021, 140 burn children with moderate or severe burns, aged 1 to 3 years, who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. During debridement and dressing change 3 to 14 days after injury, 42 children, including 23 males and 19 females, who received nurse-centered pain management mode and analgesia and sedation with nitrous oxide and oxygen mixed inhalation technology were included in nitrous oxide group (the dressing change process using the above-mentioned technology for the first time was selected for the follow-up study). Another 42 children, including 24 males and 18 females, were included in non-nitrous oxide group from 98 children who did not apply analgesia or sedation treatment during dressing change with stratified random sampling (one dressing change process was randomly selected for the follow-up study). The face, legs, activity, cry, and consolability scale and Ramsay sedation scale were used to evaluate the pain intensity and degree of sedation, respectively, at 30 minutes before dressing change (hereinafter referred to as before dressing change), immediately after debridement, and at 30 minutes after finishing dressing change (hereinafter referred to as after dressing change). After dressing change, the self-made satisfaction scale was used to evaluate the satisfaction degree of dressing change surgeons and guardians of children for analgesic effects during dressing change. The duration of dressing change and the healing time of deep partial-thickness burn wounds were recorded. The heart rate and percutaneous arterial oxygen saturation (SpO 2) before, during, and after dressing change and the occurrence of adverse events such as nausea and vomiting during dressing change were recorded. Data were statistically analyzed with Mann-Whitney U test, chi-square test, analysis of variance for repeated measurement, independent sample t test, and Bonferroni correction. Results:There were no significant differences in the score of pain intensity and score of sedation degree between children in two groups before and after dressing change ( P>0.05). Immediately after debridement, the score of pain intensity of children in nitrous oxide group was 2.5±0.7, which was significantly lower than 7.6±1.0 in non-nitrous oxide group ( t=-26.69, P<0.05); the score of sedation degree of children in nitrous oxide group was 1.83±0.38, which was significantly higher than 1.21±0.42 in non-nitrous oxide group ( t=7.15, P<0.05). After dressing change, the satisfaction degree scores of dressing change surgeons and guardians of children for analgesic effects during dressing change of children in nitrous oxide group were significantly higher than those in non-nitrous oxide group (with t values of 10.53 and 2.24, respectively, P<0.05). The dressing change duration of children in nitrous oxide group was significantly shorter than that in non-nitrous oxide group ( t=-5.33, P<0.05). The healing time of deep partial-thickness burn wounds in children between the two groups had no significant difference ( P>0.05). The heart rate of children in nitrous oxide group was significantly lower than that in non-nitrous oxide group during dressing change ( t=-12.40, P<0.05), while the SpO 2 was significantly higher than that in non-nitrous oxide group ( t=5.98, P<0.05). During dressing change, 2 children had nausea and 1 child had euphoria in nitrous oxide group, while heart rate of all children in non-nitrous oxide group continued to be higher than the normal range. Conclusions:In the process of debridement and dressing change in children with moderate or severe burns, the use of nurse-centered pain management mode and the standardized use of nitrous oxide and oxygen mixed inhalation technology can safely and effectively control pain and sedation.

Objective To observe the dynamic characteristics of hepatitis B core antibody (anti-HBc) titers in chronic hepatitis B (CHB) patients treated with interferon and to explore the predictive value of anti-HBc for response to interferon.Methods The clinical information of the patients diagnosed with CHB in Department of Infectious Diseases , the First Affiliated Hospital of Xi′an Jiaotong University from October 2011 to October 2014 were collected.HBV DNA, liver function and HBV serological markers of CHB patients were tested dynamically during and after interferon treatment.The dynamic characteristics of anti-HBc titers in patients with different virological responses were analyzed.The predictive values of anti-HBc titer for the efficacy of interferon treatment of CHB patients were analyzed by binary logistic regression .Results Of the 42 CHB patients aging(30.8 ±10.1) years old, 34 patients were hepatitis B e antigen (HBeAg) positive and 8 were negative.All patients completed 48-week interferon treatment and 24-week follow-up after the end of treatment. Among them, 28.6%( 12/42), 26.2%( 11/42 ) and 45.2%( 19/42 ) of patients achieved sustained virological response (SVR), virological relapse ( VR) and non-response ( NR), respectively.Patients with different virological response presented various characteristics of anti -HBc titers.Compared with NR group, the anti-HBc titers at baseline and week 12 were significantly higher in SVR group (at baseline: [4.93 ±0.30] vs [4.70 ±0.33] lg IU/mL, t ＝2.147, P ＝0.013; at week 12: [4.83 ± 0.23] vs [4.44 ± 0.41] lg IU/mL, t＝3.032, P＝0.007).The anti-HBc titers in SVR group at week 12 and week 24 were significantly higher than those in VR group (at week 12: [4.83 ±0.23] vs [4.67 ±0.51] lg IU/mL, t＝2.400, P＝0.039; at week 24: [4.73 ±0.21] vs [4.55 ±0.50] lg IU/mL, t＝2.542, P＝0.039).By multivariate logistic regression analysis, the anti-HBc titer at baseline was the independent predictive factor for SVR in CHB patients treated with interferon (OR＝6.000, 95%CI: 1.118 -20.486, P＝0.037).The area under receiver operating characteristics curve was 0.753 and the optimal cutoff value of anti-HBc titer for the response to interferons in CHB patients was 5.03 lg IU/mL, with positive predictive value of 64.3%and negative predictive value of 89.3%.Conclusions Dynamic pattern of anti-HBc titers is correlated with different virological responses in CHB patients treated with interferon , and the baseline anti-HBc titer is the independent predictive factor for SVR.

Objective To investigate the clinical value of serum interleukin-6(IL-6)and inter-leukin-8(IL-8)levels in combination with pulmonary function indicators in identifying severe Myco-plasma pneumoniae pneumonia(MPP)in children.Methods A total of 102 children with severe MPP were selected as the study subjects(severe group),and another 102 children with mild MPP treated during the same period were selected as the mild group.The serum levels of IL-6,IL-8 as well as forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1 percent-age of predicted(FEV1％pred)and the ratio of FEV1 to FVC at the time of admission of children in each group were compared.Results The serum levels of IL-6 and IL-8 in the severe group were sig-nificantly higher than those in the mild group,while the FVC,FEV,％pred,and FEV1/FVC％were significantly lower than those in the mild group(P＜0.05).The serum levels of IL-6 and IL-8 were negatively correlated with FVC,FEV1％pred and FEV1/FVC％(P＜0.05).The area under the curve(AUC)for assessing the severity of MPP for IL-6,IL-8,FVC,FEV1％pred and FEV1/FVC％was 0.894(0.849 to 0.939),0.842(0.787 to 0.897),0.896(0.851 to 0.942),0.787(0.725 to 0.849)and 0.744(0.676 to 0.812),respectively.The AUC for the combined assessment of the above five parameters was 0.985(0.973 to 0.997).Conclusion Serum IL-6,IL-8 and pulmonary function indicators can reflect the severity of MPP in children.Their combined detection can be used to differentiate between mild and severe MPP in children early and timely.

Objective To investigate the clinical value of serum interleukin-6(IL-6)and inter-leukin-8(IL-8)levels in combination with pulmonary function indicators in identifying severe Myco-plasma pneumoniae pneumonia(MPP)in children.Methods A total of 102 children with severe MPP were selected as the study subjects(severe group),and another 102 children with mild MPP treated during the same period were selected as the mild group.The serum levels of IL-6,IL-8 as well as forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1 percent-age of predicted(FEV1％pred)and the ratio of FEV1 to FVC at the time of admission of children in each group were compared.Results The serum levels of IL-6 and IL-8 in the severe group were sig-nificantly higher than those in the mild group,while the FVC,FEV,％pred,and FEV1/FVC％were significantly lower than those in the mild group(P＜0.05).The serum levels of IL-6 and IL-8 were negatively correlated with FVC,FEV1％pred and FEV1/FVC％(P＜0.05).The area under the curve(AUC)for assessing the severity of MPP for IL-6,IL-8,FVC,FEV1％pred and FEV1/FVC％was 0.894(0.849 to 0.939),0.842(0.787 to 0.897),0.896(0.851 to 0.942),0.787(0.725 to 0.849)and 0.744(0.676 to 0.812),respectively.The AUC for the combined assessment of the above five parameters was 0.985(0.973 to 0.997).Conclusion Serum IL-6,IL-8 and pulmonary function indicators can reflect the severity of MPP in children.Their combined detection can be used to differentiate between mild and severe MPP in children early and timely.

BACKGROUND:Neuregulin 1 has been shown to be characterized in cell proliferation,differentiation,and vascular growth.Human amniotic mesenchymal stem cells are important seed cells in the field of tissue engineering,and have been shown to be involved in tissue repair and regeneration. OBJECTIVE:To construct human amniotic mesenchymal stem cells overexpressing neuregulin 1 and investigate their proliferation and migration abilities,as well as their effects on wound healing. METHODS:(1)Human amniotic mesenchymal stem cells were in vitro isolated and cultured and identified.(2)A lentivirus overexpressing neuregulin 1 was constructed.Human amniotic mesenchymal stem cells were divided into empty group,neuregulin 1 group,and control group,and transfected with empty lentivirus and lentivirus overexpressing neuregulin 1,or not transfected,respectively.(3)Edu assay was used to detect the proliferation ability of the cells of each group,and Transwell assay was used to detect the migration ability of the cells.(4)The C57 BL/6 mouse trauma models were constructed and randomly divided into control group,empty group,neuregulin 1 group,with 8 mice in each group.Human amniotic mesenchymal stem cells transfected with empty lentivirus or lentivirus overexpressing neuregulin-1 were uniformly injected with 1 mL at multiple local wound sites.The control group was injected with an equal amount of saline.(5)The healing of the trauma was observed at 1,7,and 14 days after model establishment.Histological changes of the healing of the trauma were observed by hematoxylin-eosin staining.The expression of CD31 on the trauma was observed by immunohistochemistry. RESULTS AND CONCLUSION:(1)Human amniotic mesenchymal stem cells overexpressing neuregulin-1 were successfully constructed.The mRNA and protein expression of intracellular neuregulin 1 was significantly up-regulated compared with the empty group(P<0.05).(2)The overexpression of neuregulin 1 promoted the migratory ability(P<0.01)and proliferative ability of human amniotic mesenchymal stem cells(P<0.05).(3)Human amniotic mesenchymal stem cells overexpressing neuregulin 1 promoted wound healing in mice(P<0.05)and wound angiogenesis(P<0.05).The results showed that overexpression of neuregulin 1 resulted in an increase in the proliferative and migratory capacities of human amniotic mesenchymal stem cells,significantly promoting wound healing and angiogenesis.