Injection Stauntoniae (IS ) was applied ou a part of the saphenous nerve of rat 4mm in length. With 50% IS, amplitudes of A??, A? and C components of the compound action polential were reduced and their latencics were delayed. In particular, the amplitudcs of A? and C components reduced to 47.0% ? 23.o% and 44.0?20.0% (MEAN?SD, n = 8, P

Objective To investigate the clinical characteristics and related risk factors of infarction secondary to severe traumatic brain injury.Methods 480 traumatic brain injury patients were chosen.Depending on the occurrence of cerebral infarction,patients were divided into TCI groups and non-TCI group,clinical symptoms and signs of TCI group were observed,and its related risk factors was analyzed.Results In 480 cases patients,there were 30 cases of patients with traumatic brain injury secondary to cerebral infarction,the rate was 6.25%.Clinical manifestations included unilateral limb motor and sensory dysfunction,visual dysfunction,language dysfunction,dizziness,headache.10 cases Prognosis were good,6 cases were mild disability,3 cases were severe disability,1 case was plant survival,10 patients died.Univariate analysis showed that the rates of aged ≥50 years,GCS score ＜ 8 points,hernia,hypotension,subarachnoid hemorrhage,large doses of non-dehydrating agent in the TCI group were higher than those of non-TCI group,the differences were statistically significant (x2 =12.311 3,14.725 4,19.867 8,5.296 9,9.242 6,11.713 6,all P ＜ 0.05).Logistic multivariate analysis showed that age ≥50 years,GCS score ＜ 8 points,hernia,cerebral hypotension were important risk factors.Conclusion Brain injury patients with cerebral infarction secondary to clinical manifestations have some characteristics.Age ≥50 years,GCS score ＜ 8 points,hernia,hypotension are important risk factors.

AIM:To determine imperatorin in Qianzhi Capsules(Radix Rubiae, Radix Angelicae Dahuricae, etc.). METHODS:RP-HPLC was applied. The mobile phase consisted of methanol: 5% phosphoric acid solution(70∶30). The detection wavelength was at 248nm and the flow rate was 1.0mL?min -1. RESULTS:The linearity was obtained in the range of 12～60?g?mL -1(r=0.9998). The average recovery was 99.8% with relative standard deviation of 1.0%. CONCLUSION:The method was simple and reliable.

With the development of virtual reality, augmented reality, and mixed reality technology, their application in medical education has become increasingly widespread. With the advantages of virtuality-reality combination, real-time interaction and exact registration, mixed reality technology is expected to improve the drawbacks of traditional medical education, and exerts great potential in virtual classroom, virtual laboratory, anatomy teaching, medical operation training, surgery simulation, and telemedicine education. This article mainly introduces the applications of mixed reality technology in medical education in recent years, and hopes to provide a reference for the integration of mixed reality technology into the field of education.

With the development of information technology,the concept of smart healthcare has gradually come to the fore.Smart healthcare uses a new generation of information technologies,such as the internet of things (IoT),big data,cloud computing,and artificial intelligence,to transform the traditional medical system in an all-round way,making healthcare more efficient,more convenient,and more personalized.With the aim of introducing the concept of smart healthcare,in this review,we first list the key technologies that support smart healthcare and introduce the current status of smart healthcare in several important fields.Then we expound the existing problems with smart healthcare and try to propose solutions to them.Finally,we look ahead and evaluate the future prospects of smart healthcare.

Objective To detect the level of plasma microRNA-1 (miR-1) in acute myocardial infarction (AMI) and compare the diagnostic values of it with that of cardiac troponin T (cTnT).Methods During 2011-05 to 2012-05,there were fifty-six plasma samples taken from patients with AMI and twenty-eight plasma specimens got from non-AMI controls were analyzed.The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR),and the level of plasma cTnT was measured by using electrochemiluminescence-based methods on the Elecsys 2010 Immunoassay Analyzer.Then,the SPSS 16.0 was used for the statistical analysis.Data were presented as means ± standard deviation unless otherwise described.The differences about clinical characteristics between AMI patients and controls were tested using Student' s t-test or Fisher' s exact test.The Mann-Whitney test was conducted to compare the expression of microRNAs between the AMI patients and controls.The comparison of microRNAs expression between different intervals of AMI patients was done using Wilcoxon signed rank test.The receiver operating characteristic (ROC) curve was established to discriminate AMI patients from controls.Results The expression of plasma miR-1 was significantly increased in AMI patients (P ＜ 0.01) compared with healthy controls.The contents of the plasma miR-1 in AMI patients fell down nearly to the normal level at 14 days (P ＞ 0.05).There was no relevance between the expression of plasma miR-1 and the clinical characteristics of the study population (P ＞ 0.05).Moreover,ROC curve analyses demonstrated that miR-1 had the specificity and sensitivity for the diagnosis of early AMI,but was not superior to cTnT.Conclusions Our results showed that plasma miR-1 had the capacity in early diagnosis of early AMI,and can be biomarker for AMI,however,miR-1 is not superior to cTnT for the diagnosis of AMI.

Objective To investigate the effect of intramuscular and oral mecobalamin on hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.Methods One hundred and twenty-six patients with vitamin B12 deficiency who fulfilled the inclusion criteria were randomly divided into 3 groups,42 cases in each,including the intramuscular group (to receive mecobalamin therapy intramuscularly),the oral group ( to receive mecobalamin therapy orally) and the control group ( without mecobalamin therapy).The changes of hematologic markers including hemoglobin (Hb,g/L),mean corpuscular volume (MCV,fl),serum levels of vitamin B12 (ng/L),folate and total homocysteine (Hcy,μmol/L),and neurological signs before and after treatment were compared among these groups.Results Baseline characteristics among the three groups were similar.After a 6-month therapy,there were no differences in any markers in control group patients in comparison to baseline;for patients in the intramuscular group,the blood vitamin B12 levels increased from (139.13 ± 31.57)ng/L to (328.10 ± 42.35 )ng/L (P ＜ 0.001 ).Hcy levels decreased from (36.29 ± 16.23 )μmol/L to ( 18.23 ± 9.85 ) μmol/L ( P ＜ 0.001 ).Hb rose from ( 125.34 ± 16.21 ) g/L to ( 132.79 ± 15.98 )g/L (P =0.037).MCV reduced from (92.98 ±5.35)fl to (87.65 ±5.74)fl (P ＜0.001 ) ;For patients in the oral administration group,the blood vitamin B12 levels increased from ( 138.19 ± 29.95) ng/L to (487.79 ±32.21 ) ng/L ( P ＜ 0.001 ).Hcy levels decreased from ( 33.27 ± 11.51 ) μmol/L to ( 17.49 ± 10.13 ) μmol/L( P ＜ 0.001 ).Hb rose from ( 125.89 ± 17.65 ) g/L to ( 133.46 ± 16.26) g/L ( P =0.041 ).MCV reduced from (93.08 ± 5.10 ) fl to ( 89.29 ± 5.37 ) fl ( P =0.001 ).After the 6-month therapy,there were somewhat improvement in MMSE scores of the intramuscular ( 28.24 ± 3.89 vs.27.85 ± 3.56,P =0.633 ) and the oral groups (27.97 ± 3.77 vs.27.34 ± 3.15,P =0.408 ) compared with baseline,but the differences were not significant.The achilles tendon reflex of the intramuscular ( 1.86 ± 0.67 vs.1.56 ± 0.61,P =0.035 ) and the oral groups ( 1.79 ± 0.64 vs.1.43 ± 0.51,P =0.006 ) were enhanced compared with baseline.Foot vibration sensation of the intramuscular ( 1.35 ± 0.37 vs.1.06 ± 0.41,P =0.001 ) and the oral groups ( 1.24 ± 0.52vs.1.01 ± 0.43,P =0.03) were improved compared with baseline.After treatment,the serum VitB12 concentration in the oral group were higher than that of the intramuscular group ( P ＜ 0.001 ).There were no significant differences in other indexes between the two groups.Conclusion Mecobalamin,administered either intramuscularly or orally,may improve the hematologic markers and neurologic signs in elderly patients with vitamin B12 deficiency.

Objective:To evaluate the effectiveness of integrated pediatric training course of extracorporeal membrane oxygenation(ECMO)based on simulation teaching.Methods:The instructors of ECMO team of Children′s Hospital of Fudan University developed the teaching curriculum.Team members as a unit were recruited to study simulation-based courses, whose theoretical knowledge, skills and teamwork were assessed, and feedback from the trainees were gathered.Results:Since May 2018, 22 teams of pediatric specialized hospitals or general hospitals have taken part in our ECMO simulation, with totally 132 participants, including 45 ICU doctors(34.1%), 60 ICU nurses(45.5%), 23 thoracic surgeons(17.4%) and four anesthesiologists(3.0%). Twelve of them(9.1%)had a little ECMO experience.After training, the trainees had a high evaluation on each part of the course, with average score more than four, of which the theoretical score was lowest.Their self-evaluation on the theory, skills, teamwork and confidence in the implementation of ECMO had been significantly improved.Most(80.3%)of the trainees were confident to carry out ECMO in their local hospitals.The trainees′ baseline score of theoretical knowledge was 55.2±7.6, and increased to 67.1±7.3 after training( P<0.001). The average teamwork score of the 22 teams was 70.2±8.2, and the qualified rate was up to 86.4%.The most prominent skill problems in operation assessment were no albumin and blood priming(90.9%), non-skill problems were extremely anxious during the overall assessment(84.8%)of the participants, poor team work(74.2%), poor leadership(68.2%). For the feedback of the whole course, 97.0% and 94.7% of the trainees thought that integrated training and simulation teaching were the highlights of the course.At present, 13(59.1%)units have successfully developed ECMO technology after the course, and the number of children treated has been up to 83, with a survival rate of discharge of 54.2%.However, it was found that the skill level of some participants decreased about 2 weeks after the course. Conclusion:As a new attempt of ECMO teaching, this curriculum has achieved certain efficiency in both teaching and clinical practice.At the same time, our study also plays a role in promoting the development of ECMO in pediatrics.

Objective To investigate the microsurgical managements of intracranial ruptured aneurysms combined with intracranial hematomas and to observe their therapeutic efficacy.Methods A total of 32 patients with intracranial ruptured aneurysms combined with intracranial hematomas,treated in our hospital from January 2009 to January 2013,were chosen in our study;18 male and 14 female patients ranged from 32 to 78 years old (mean age of 55 years) were enrolled,with sudden headache,vomiting,disturbance of consciousness as the first symptoms.The preoperative status on admission was Hunt-Hess grade Ⅲ in 7,grade Ⅳ in 20 and grade Ⅴ in 5.Radiographic imaging demonstrated 7 anterior communicating artery aneurysms,3 posterior communicating artery aneurysms,7 internal carotid artery aneurysms,13 middle cerebral artery aneurysms and 2 multiple aneurysms.The associated hematoma was greater than 20 mL.All patients were brought emergently to the operating room and treated with aneurysm clipping within 72 h.Decompressive craniectomy was performed in 19 patients,and external ventricular drainage was performed in 19 patients.Results Postoperative follow up (ranged from 3-24 months) showed good recovery,moderate recovery,severe disability,persistent vegetative state and death in 6,12,11,0 and 2,respectively,graded by Glasgow Outcome Scale;the remaining one patient was lost to follow-up.The percentage of good prognosis in patients with preoperative Hunt-Hess grade of Ⅲ grade (84.6％) was higher than that of patients with Ⅳ-Ⅴ grade (36.8％,P＜0.05).Conclusions Early evacuation of space-occupying hematoma,aneurysm clipping and emergent decompessive cranioctomy could lead to survival with good recovery in some patients.

OBJECTIVETo optimize the method of Fructus Auranti extracts preparation.

METHODThe extraction conditions and resin type were examined by using naringin as main indices. The sampling amount, the elution solvent and their flow rates were optimized. The recycling times and recovery capacity of resin were also studied.

RESULTThe best extraction could be obtained by adding 10 times amount of NaOH (pH 11) for 3 times, 1 hour each time. The purification conditions were specified as follows: using D101 macroporous resin, the sampling ratio of resin weight to raw material was 1:0.8 with a flow rate of 2 BV x h(-1) and 4 BV 50% aqueous ethanol as elusion solven.

CONCLUSIONBy using this method, the naringin in the product could reach above 30%. Besides, the optimum method is simple and practical.

Chemical Fractionation ; methods ; Citrus aurantiifolia ; chemistry ; Flavanones ; analysis ; isolation & purification ; Fruit ; chemistry ; Plant Extracts ; analysis ; isolation & purification