Objective Infrared spectroscopy was used to study on both raw material and different degree water processing varieties extract of Radix Aconiti kusnezoffii,to observe the changes of main toxic components in processing,and thus to improve the quality of Radix Aconiti kusnezoffii processed products.Methods Fu Liye transform infrared spectroscopy was adopted to study the infrared spectrum characteristic of raw materials and different degree water processing varieties of.Radix Aconiti kusnezoffii.Results ①Aconitine and hypaconitine infrared spectrum showed that 1717 cm-1,1727 cm-1 and 1711 cm-1 is the C=O stretching vibration peak.It is a diester alkaloids characteristic peaks; ② although absorption peak of all vesicular samples had a certain change,it still existed diester alkaloids absorption peak,indicating the incomplete hydrolysis; ③ boiled aconite processing methods demonstrated diester alkaloids absorption peak shift in the water sample.Conclusion Diester alkaloids in Radix Aconiti kusnezoffii shows a positive relation with its time soaked in water.

The professional quality training ofthree orientedpersonnel training mode is one of the three core, which requires medical students to have lifelong learning ability. This study mainly describes the proposed concept of lifelong learning ability, expounds the necessity of lifelong learning ability, and analyzes the connotation, objective and strategies of improving the medical students'!lifelong learning ability under the framework of three oriented medical talents training mode. The training strategy has been discussed mainly from five aspects such as strengthening medical humanistic education, creating a lifelong learning atmosphere in campus, optimizing teaching methods, reform the course of career development and employ-ment guidance, reforming the course of career development and employment guidance, reforming the teaching of medical literature retrieval course and establishing the personal growth archives.

OBJECTIVETo investigate the biocompatibility and degradation rate of crosslinking sodium hyaluronate gel with different ratio of molecular weight, so as to choose the effective, safe and totally degraded hyaluronate gel for aesthetic injection.

METHODS(1) Compound colloid was formed by cross-linking the divinyl sulphone and sodium hyaluronate with different molecular weight (4 x 10(5), 8 x 10(5), 10 x 10(5), 12 x 10(5)). (2) Healthy level KM mice was randomly divided into two groups to receive hyaluronic acid gel or liquid injection. Each group was subdivided into three subgroup to receive hyaluronic acid with different molecular weight. The biocompatibility and degradation rate, of hyaluronate were observed at 7, 90, 180 days after injection. At the same time, different molecular weight of sodium hyaluronate gel is sealed or exposed respectively under the low temperature preservation to observe its natural degradation rate. (3) The most stable colloid was selected as aesthetic injector for volunteers to observe the aesthetic effect.

RESULTSThe sodium hyaluronate gel with molecular of 4 x 10(5) was completely degraded 90 days later. The sodium hyaluronate gel with molecular of 8 x 10(5) was completely degraded 180 days later. The sodium hyaluronate gel with molecular of 10 x 10(5) was degraded to 90.0% after 180 days. The sodium hyaluronate liquid can be degraded completely within 7 days. The colloid could be kept for at least 12 months when sealed under low temperature, but was totally degraded when exposed for I d. Sodium hyaluronate gel with molecular 10 x 10(5) was confirmed to be kept for at least 6 months in animal experiment and clinical trials.

CONCLUSIONSUnder the same condition of material ratio, the higher the molecular weight is, the lower the degradation rate is. But the liquidity of gel is not good for injection when molecular weight is too large. It suggests that Sodium hyaluronate gel with molecular 10 x 10(5) maybe the best choice in cosmetic injections.

Animals ; Cross-Linking Reagents ; administration & dosage ; chemistry ; Hyaluronic Acid ; administration & dosage ; chemistry ; Injections, Subcutaneous ; Mice ; Molecular Weight ; Random Allocation

Objective:To investigate the correlation between serum forkhead box protein P1 (FOXP1) and cyclin-dependent kinase2 (CDK2) and bone mineral density in perimenopausal women with osteoporosis (OP) .Methods:A total of 80 perimenopausal women treated in our hospital from Feb. 2021 to Aug. 2022 were selected as study objects. Among them, 38 were in the OP group and 42 were in the control group. The expression levels of FOXP1 and CDK2 in serum were detected by ELISA. BMD expression levels of lumbar spine (L1-L4) and femoral neck were measured by DEXA BMD analyzer. The correlation between serum FOXP1 and CDK2 and bone mineral density in perimenopausal women with osteoporosis was analyzed by Pearson method.Results:Compared with the control group, the contents of FOXP1 and CDK2 in serum of the control group were (42.94±3.37) pg/ml and (102.46±12.247) pg/ml, respectively. Serum FOXP1 and CDK2 contents in OP group were (25.91±4.38) pg/ml and (60.59±10.777) pg/ml, respectively. Compared with the control group, serum FOXP1 and CDK2 expression levels and bone mineral density of lumbar spine (L1-L4) and femoral neck in OP group were significantly decreased. The BMD of lumbar spine (L1-L4) and femoral neck of women in the control group were 0.68±0.28 and 0.43±0.99, respectively. BMD of lumbar spine (L1-L4) and femoral neck of women in the OP group were 0.40±0.10 and 0.21±0.15, respectively. Bone mineral density decreased in the lumbar spine (L1-L4) and femoral neck in the OP group. The differences were statistically significant ( P<0.05). In addition, the correlation analysis results showed that the expression level of FOXP1 in serum was positively correlated with bone mineral density of lumbar spine (L1-L4) and femoral neck ( r=0.546, 0.245, P<0.05), and the expression level of CDK2 was positively correlated with bone mineral density of lumbar spine (L1-L4) ( r=0.600, P<0.05) . Conclusions:In perimenopausal women with osteoporosis, the expression of FOXP1 and CDK2 in serum was significantly decreased, and there was a correlation with bone mineral density. It is suggested that FOXP1 and CDK2 may be used as biological indicators and clinical predictors of osteoporosis in perimenopausal women.

OBJECTIVE: To explore the therapeutic efficacy and complications of endoscope-assisted surgical resection of acoustic neuroma. METHOD: Assisted by hard-tube ear endoscope, 11 patients with acoustic neuroma were operated via labyrinthine approach and retrosigmoid approach. RESULT: Total removal was achieved in 9 (81.8%) cases, while subtotal removal was achieved in 2 (18.2%) cases. Facial nerves and cochlear nerves were preserved completely during operation in all cases. After operation 9 (81.8%) cases had no facial paralysis, while the other 2 cases (18.2%) had mild peripheral facial paralysis. The same hearing level as that of preoperation in 2 patients (18.2%), hearing impairment in different degrees in 9 patients (81.8%), among which moderate sensorineural hearing loss in 1 patient, moderate to severe in 2 patients, severe in 3 patients, profound in 3 patients. CONCLUSION The application of ear endoscope in acoustic neuroma surgery can improve the total removal rate of tumors and the salvage rate of vessels and nerves. However, its disadvantages make it an assistant method for microsurgery.
Adult ; Ear, Inner ; surgery ; Endoscopy ; Female ; Humans ; Male ; Microsurgery ; Middle Aged ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods ; Young Adult

Under normal conditions,insulin secreted by the pancreas enters the liver through the portal vein,forming a difference in insulin concentration above the peripheral circulation.Subcutaneous administration of insulin forms a portal-peripheral concentration gradient of insulin above the liver,which is inconsistent with normal physiological conditions.Intraperitoneal insulin administration has been extensively investigated because that is closer to physiological state.In this paper,the pharmacokinetic and pharmacodynamic studies of insulin intraperitoneal administration were reviewed.Compared with the conventional subcutaneous delivery,intraperitoneal insulin administration can not only reduce the incidence of hypoglycemia,but also has the advantage of correcting abnormal lipid metabolism.This means that intraperitoneal administration of insulin has a positive effect on the prevention and treatment of diabetic complications.Therefore,it is necessary and feasible to develop a safe,low-cost,and easy-to-use percutaneous intraperitoneal insulin delivery device.

Clinical microbiology examination technology experiment is an important part of clinical microbiology examination technology teaching. In the experimental teaching of clinical microbiology examination technology, the virtual simulation technology was combined with traditional teaching to give full play to the advantages of the virtual experimental platform. As to experimental projects that couldn't be carried out in traditional teaching and some important experimental projects, students could learn on the virtual experimental platform, and after learning, they would participate in the corresponding assessment. The perfect combination of the two can solve the problem of high experimental cost and limited experimental content in the current experimental class, make up for the shortcomings of traditional teaching, realize the sharing of teaching resources. Besides, it can strengthen the students' experimental operation skills and enhance the interest of learning for cultivation of application-oriented medical talents.

Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) at admission for stroke associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to the First Affiliated Hospital of Kunming Medical University from January 2019 to June 2020 were retrospectively included. The demographic information, vascular risk factors, severity of stroke at admission, and NLR data of the patients were collected. Multivariate logistic regression was used to analyze the independent correlation between NLR and SAP. The NLR was divided into quartile groups to further analyze the trend relationship between NLR and SAP. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of NLR for SAP. Results:A total of 316 patients with AIS were enrolled, including 200 males (63.29%) with an age of 63.86±13.78 years. The median baseline Nationanl Institutes of Health Stroke Scale score was 4 (interquartile range, 2-9), and the median NLR was 4.42 (interquartile range, 3.17-6.70). Ninety-three patients (29.43%) experienced SAP. Multivariate logistic regression analysis showed that NLR was an independent risk factor for SAP in patients with AIS (odds ratio 1.189, 95% confidence interval 1.077-1.313; P<0.001). Moreover, SAP risk increases with the increase of NLR ( Ptrend<0.001). Compared to the first quartile, the risk of SAP increased 9.991 times in the fourth quartile (95% confidence interval 2.912-34.279; P<0.001). ROC curve analysis showed that the area under the curve of NLR for SAP prediction was 0.793 (95% confidence interval 0.737-0.850), with an optimal cutoff value of 5.475. The sensitivity and specificity for predicting SAP were 66.67% and 79.82%, respectively. Conclusion:NLR at admission is an independent risk factor for SAP in patients with AIS and has certain predictive value for SAP.

BACKGROUND:One-hole split endoscope technique has been widely used in the treatment of lumbar degenerative diseases,but there is no relevant literature on the safety analysis of this technique in the treatment of upper lumbar disc herniation. OBJECTIVE:To observe the position relationship of nerve roots,intervertebral space and bone landmarks in the upper lumbar spine by three-dimensional lumbar CT reconstruction technology,and to provide a basis for the clinical operation of one-hole split endoscope surgery. METHODS:Twenty-six patients with upper lumbar disc herniation underwent a lumbar CT scan.Mimics 17.0 software was imported to measure the related imaging parameters of L1/2 to L3/4 segments:(1)Measurement of vertical distance:In coronal view,the distance(a)from the intersection point of the medial facet of the superior articular process and the superior endplate(N)to the apex of the articular process(S);in the coronal view,the distance(b)from the sagittal intersection(M)of N and the inferior endplate to the apex of the inferior articular process(X).(2)Measured horizontal distance:the distance(c)between the cross-section of N and the lower edge of the outlet nerve root(N2);distance(d)between the cross-section of N and the intersection point of neural tissue(N1);N1 to N2 distance(e);distance(f)between the cross-section of M and the lateral edge of the nerve tissue(M1);M to M cross-section and exit nerve root intersection(M2)distance(g);distance(h)from M1 to M2;distance(i)from M2 to N1;distance(j)from the posterior edge of the articular surface(R)to M2 in sagittal view of the superior articular process. RESULTS AND CONCLUSION:(1)With the decrease of the segment,the distances a and b gradually increased,and the distance j gradually decreased.There was no significant difference between L1/2 and L2/3 segments(P>0.05).(2)With the decrease of the segment,distance d first decreased and then increased;distance f gradually decreased;distances c,e,g,h and i gradually increased;and there was no significant difference between L2/3 and L3/4 segments(P>0.05).(3)Distance i was the shortest distance without pulling nerve roots in the natural state,and the area of the safety zone was between four points M1,M2,N1,and N2.The bone was removed to the upper and lower endplates by biting the bone downward and upward through S and X,respectively,to expose the intervertebral space,and the window of distance g to M2 could be opened outward to avoid injury of the outlet nerve roots.(4)In conclusion,the upper lumbar vertebrae have unique anatomical characteristics.Based on the relevant measurements of nerve roots,spinal dura and intervertebral space,the parameters of the one-hole split endoscope technique are more accurate and safe during operation.

Objective:To investigate the clinical features and associated influencing factors of cognitive impairment in middle-aged and elderly Chinese adult patients undergoing maintenance hemodialysis (HD).Methods:A cross-sectional study was conducted among HD patients from 11 centers in Beijing city from April 2017 to June 2017. A neuropsychological battery covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied in cognitive function assessment. Patients were classified as normal cognitive function group and cognitive impairment group according to the fifth version of the diagnostic and statistical manual of mental disorders criteria (DSM-V). Multivariate binary logistic regression was used to analyze the independent influencing factors of cognitive impairment. Results:A total of 613 HD patients were included in the study, and the prevalence of cognitive impairment was 80.91% (496/613). Attention impairment (81.05%) and memory impairment (63.51%) were the most common impaired domains, and 79.23% was concomitant impairment across two or more cognitive domains among those with cognitive impairment. Compared with the patients in the normal cognitive function group, the patients in the cognitive impairment group had senior age, longer dialysis vintage, higher proportion of diabetes, hypertension, and stroke, higher level of serum intact parathyroid hormone (iPTH), lower education level, and lower urea clearance index (Kt/V) (all P<0.05). Factors were independently associated with cognitive impairment including increasing age ( OR=1.110, 95% CI 1.072-1.150, P<0.001), education time>12 years (with education time<6 years as reference, OR=0.323, 95% CI 0.115-0.909, P=0.032), history of diabetes ( OR=2.151, 95% CI 1.272-3.636, P=0.004), history of stroke ( OR=2.546, 95% CI 1.244-5.210, P=0.011), increased dialysis vintage ( OR=1.016, 95% CI 1.010-1.022, P<0.001), reduced Kt/V( OR=0.008, 95% CI 0.002-0.035, P<0.001), and increased iPTH level ( OR=1.002, 95% CI 1.002-1.003, P=0.012). Conclusions:The prevalence of cognitive impairment in middle-aged and elderly adult Chinese patients undergoing HD is high. Memory and attention are the most commonly impaired domains. Increasing age, low education level, history of diabetes and stroke, increased dialysis vintage, reduced Kt/V and increased serum iPTH are the independent influencing factors associated with cognitive impairment.