Geriatrics develops relatively late in medical education, but geriatric medical education is rapidly rising for aggravation of the aging of population.And geriatric medical education is desired of the properties medical sciences, and is also the need of the development itself. Therefore, geriatric medical education should be internationalized, to eventually form distinctive education.

BACKGROUND: Prognosis is determined by degrees of outside force and time of spinal cord compression after spinal cord injury. The former factor cannot be changed, but the latter one can be changed through relieving spinal cord compression as early as possible to promote nervous function recovery.OBJECTIVE: To compare the effect of surgical intervention time on nervous function recovery within 72 hours and 10 to 14 days after cervical spinal cord injury.DESIGN: Randomized controlled and before-after controlled study.SETTING: Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University.PARTICIPANTS: A total of 32 patients with cervical spinal cord injury were selected from the Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University from April 1998 to August 2001.All patients were divided into two groups according to randomly alternative criteria. There were 16 cases including 10 males and 6 females in early surgical group (within 72 hours) and there were also 16 cases including 12males and 4 females in delayed surgical group (within 10-14 days).METHODS: Patients in early surgical group were undertaken operation at 72 hours after hospitalization, and patients in delayed surgical group were at 10-14 days after hospitalization. Frankel grade, sensory and motor scores were recorded according to criteria set by American Spinal Injury Association before operation and within 24 months after operation.MAIN OUTCOME MEASURES: ① Sensory and motor scores before and after operation; ② Frankel grade before and after operation.RESULTS: ① Improved level of sensory score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (42.6±20.2, 19.2±19.1, P ＜ 0.01). ② Improved level of motor score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (39.7±17.8, 17.3±18.6, P ＜ 0.01). ③Improved level of Frankel grade in early surgical group was superior to that in delayed surgical group (P ＜ 0.01).CONCLUSION: Nervous function recovery of patients with acute cervical spinal cord injury who were suffered from operation within 72 hours is superior to that of those within 10 to 14 days. Therefore, surgical intervention should be undertaken as early as possible in order to promote nervous function recovery after cervical spinal cord injury.

Using the Gram-positive Staphylococcus aureus as the indictor bacterium,fourteen antibacterial strains were initially obtained by the bilayer-media screening method from the raw milk samples,and one isolate was found to exhibit the higher antibacterial activity against the indicator. This isolate was further studied on its individual and cultural morphology features,partial physiological and biochemical reaction activities,G+C content,the sequence features of the 16S rDNA and the species-specific N-acetylmuraminidase gene(acmA) ,consequently,it was identified as the Lactococcus lactis subsp. lactis strain,named as MB191. An evaluation of the antimicrobial spectra of MB191 was subsequently performed,it showed the remarkable activities against not only the tested Gram-positive bacteria,but also several Gram-negative bacteria including Pseudomonas syringae and P. fluorescens,as well as the yeast Debaryomyces hansenii,which was a distinctive feature that was not reported prior to this study.

The technique of liquisolid compress is a new technique developed in 1990s, which was considered to be the most promising technique to improve the dissolution of water-insoluble drugs. In this article, tanshinone II(A) and the extracts of the ester-solubility fractions were chosen as the model drugs to evaluate the effects of the liquisolid technique for enhancement of dissolution properties of tanshinone II(A). Several liquisolid tablets (LS) formulations containing different dosage of drugs and various liquid vehicle were pre-pared and for all the formulations, microcrystalline cellulose and silica were chosen as the carrier and coating materials to evaluate their flow properties, such as angle of repose, Carr's compressibility index and Hausner's ratio. The interaction between drug and excipients in prepared LS compacts were studied by differential scanning calorimetry(DSC) and X-ray powder diffraction (XRPD). The dissolution curves of tanshinone II(A) from liquisolid compacts were investigated to determine the technique's effect in improving the dissolution of tanshinone II(A) and its impacting factors. According to the results, the dissolution increased with the rise in the dissolution of the liquid-phase solvent. The R-value and drug dosage can significantly affect the drug release, but with less impact on active fractions. This indicated that liquisolid technique is a promising alternative for improvement of dissolution property of water-soluble drugs, and can make a synergistic effect with other ester-soluble constituents and bettern improve the release of tanshinone II(A). Therefore, the technique of liquisolid compress will have a better development prospect in traditional Chinese medicines.
Calorimetry, Differential Scanning ; Diterpenes, Abietane ; chemistry ; Solubility ; X-Ray Diffraction

OBJECTIVETo observe the clinical effect of acupuncture on acute heart failure (AHF) patients.

METHODSTotally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups.

RESULTSAfter 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05).

CONCLUSIONThe combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Failure ; physiopathology ; therapy ; Heart Rate ; Humans ; Male ; Middle Aged ; Stroke Volume

Cell Transformation, Neoplastic ; drug effects ; genetics ; Dimethyl Sulfoxide ; pharmacology ; Electroporation ; methods ; HL-60 Cells ; Humans ; Membrane Proteins ; genetics ; Neoplasm Proteins ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Stromal Interaction Molecule 1 ; Transfection

Adolescent ; Asthma ; blood ; Child ; Child, Preschool ; Cough ; blood ; Eosinophil Cationic Protein ; blood ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male

Adult ; Antigens, Neoplasm ; metabolism ; Gastrointestinal Neoplasms ; metabolism ; pathology ; surgery ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; MART-1 Antigen ; Male ; Neoplasm Proteins ; metabolism ; Osteoclasts ; pathology ; S100 Proteins ; metabolism ; Sarcoma, Clear Cell ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery

OBJECTIVETo study the effect of acupuncture on the immune function of sepsis patients.

METHODSNinety sepsis patients were assigned to the control group, the thymosin a1 group, and the acupuncture treatment group according to random digit table, 30 patients in each group. Patients in the control group were treated according to the guideline of Surviving Sepsis Campaign (SSC). Patients in the control group received routine treatment. Those in the thymosin alpha1 group additionally received subdermal injection of thymosin alpha1 (1.6 mg), once per day for 6 successive days. Needling at related points such as Zusanli (ST36), Yanglingquan (GB34), Neiguan (PC6), Guanyuan (RN4), and so on, was performed in patients of the acupuncture treatment group, once per day for 6 successive days. T cell subgroups (CD3+, CD4+, CD8+, CD4+ /CD8+) and immunoglobulin levels (IgG, IgA, IgM) were detected. The length of ICU hospital stay, hospital readmission rate, and 28-day mortality were compared among the three groups.

RESULTSAfter six days of treatment, CD3+, CD4+, CD8+, IgG, IgA, IgM, and CD4+ /CD8+ ratio of three groups were all significantly increased (P < 0.01). Of them, CD3+, CD4+, CD8+, IgG, IgA, and IgM increased more significantly in the thymosin alpha1 group and the acupuncture treatment group (P < 0.01). Compared with the control group, the ICU hospitalization length was significantly shortened, the hospital readmission rate and the 28-day mortality were lower in the thymosin alpha1 group and the acupuncture treatment group (P < 0.05, P < 0.01). There was no statistical difference in each index between the thymosin alpha1 group and the acupuncture treatment group (P > 0.05).

CONCLUSIONAcupuncture could adjust the immune function of sepsis patients, improve their immunological indicators and prognoses.

Acupuncture Therapy ; CD4-CD8 Ratio ; Humans ; Length of Stay ; Prognosis ; Sepsis ; diagnosis ; immunology ; therapy ; T-Lymphocyte Subsets ; Thymosin ; analogs & derivatives

Objective:To investigate the relationship between the changes in inflammatory markers levels and the onset of post-traumatic stress disorder (PTSD) in the early stage of acute trauma..Methods:From January 2018 to June 2020, patients with acute trauma who were admitted to the Affiliated Hospital of Xuzhou Medical University were selected as subjects. Peripheral venous blood was collected on admission, on the 3rd and 7th day after trauma for routine blood test, C-reactive protein (CRP) and procalcitonin (PCT). The neutrophil to lymphocyte ratio (NLR) was calculated. The PCL-5 scale was used to evaluate PTSD symptoms one month later. The patients were divided into the PTSD group and non-PTSD group with the score of 38 as the boundary. The change rule of NLR in the PTSD group and the non-PTSD group were analyzed.Results:Ninety-one trauma patients were enrolled, including 23 patients in the PTSD group and 68 patients in the non-PTSD group. Compared with the healthy control group, the NLR of 91 trauma patients on admission, on the 3rd and 7th day were significantly higher (all P< 0.01). The NLR of the PTSD group was increased on the 7th day after trauma, which was significantly higher than that of the non-PTSD group ( P= 0.025). The non-PTSD group showed a decreasing trend, of which NLR on the 7th day was significantly lower than that on admission ( P= 0.001). In addition, high level of NLR on the 7th day after trauma (β= 0.206, P= 0.01) was a risk factor for PTSD onset. Conclusions:Dynamic monitoring of the changes in NLR after acute trauma would be of great clinical value to early warning of PTSD.