Purpose] This paper aims to summarize the clinical practice of using Buzhong Yiqi Decoction to treat the obstructed nine orifices. [Approach] After explaining Li Dongyuan’s theory that those obstructed nine orifices reflecting headaches and tinnitus are caused by intestines and stomach diseases,which is in his Suwen On Deficiency and Excess and analyzing several simple cases of using buzhong yiqi decoction to treat the obstructed nine orifices,this paper tries to trace the theoretical origin of Prof. Lian’s practice and present the practical experience of flexible usage of Buzhong Yiqi Decoction. [Result] The outcome of several patients under treatment shows that the short-and-mid-term treatment is very effective. [Conclusion] Prof. Lian’s philosophy of traditional Chinese medicine reflects his attitude that “those patients suffering from insufficiency of primordial Qi and clear Yang failing to distribute”or“clear Yang coming out of stomach”ask for strengthening the spleen and stomach so their stomach recovers to the healthy state. As a result,their Yang Qi has been greatly improved,the spleen and stomach in the middle energizer have returned to their original place,reaching the autonomous regulation of the nine orifices,which has shed some light on the usefulness of Buzhong Yiqi on treatment diseases other than those of spleen and stomach.

[Objective]To sum up pro. Lian Jianwei’s clinical experience in treating acne. [Method] By proved recipe analysis, it shows pro. Lian Jianwei ’s treatment based on differentiation of signs from different angles and the clinical thought of flexibly applying ancient formulae on acne. [Result] Pro. Lian Jianwei is good at revising ancient formulae for treating acne with good effect, according to patients ’pulse signs and mechanism;if the food is stagnated in the gastric-intestine, which wil transform into heat and up along the channel, Baohe Pil shal be used to remove stagnation and heat; if the liver is de-pressed with heat, deficient blood and weak spleen, Xiaoyan Powder shal be used for regulation and stretching the wood; use Wenqing Drink to nourish blood and remove toxin for deficient blood and hot liver, toxic heat implicated in spleen and stomach; apply Zisheng Pil to regulate and tonify middle part of the body for deficient spleen and stomach with turbidness and dyspepsia, etc. [Conclusion] Pro. Lian Jianwei has rich clinical experience, his clinical thought of “treatment based on differentiation of signs, with flexible methods and formulae, coping with shifting diseases by sticking to a fundamental principle”, worthy our deep experiencing and study.

This study was aimed to distinguish Leonurus japonicus samples produced from different regions and growth environments in Sichuan by electronic nose. The sensor response value of odors of Leonurus japonicus sam-ples were obtained through electronic nose. Principal component analysis (PCA) and discriminant factor analysis (DFA) were used to combine the optimum feature parameters. The results showed that the PCA distinguish index was 82, and the DFA comprehensive classification rate was 97.96% among samples from different regions. The PCA distin-guish index was 84, and the DFA comprehensive classification rate was 100% among samples from different growth environments. The distinguishment and differentiation were effective. It was concluded that electronic nose can be ap-plied to identify the origin and growth environment of Leonurus japonicus from Sichuan to provided reference for odor differentiation.

With the development of China's economy and aging of the population,patient's demands for nursing are increasingly high,thus it is very important to cultivate high-end and practical nursing personnel.This paper analyzes the necessity and feasibility of the development of Nurse Practitioner in China,and explores the qualifications and management of Nurse Practitioner,the job content of Nurse Practitioner,and the training of Nurse Practitioner.

Objective:To analyze the clinical characteristics and prognostic factors of gastric stump cancer.Method:The clinical data of 126 gastric stump cancer patients from Jan 1995 to Dec 2014 were collected . We analyzed the survival and prognosis of patients in terms of gender, tumor location, size, clinicopathological stage and treatment methods.Results:For primary surgery, B-Ⅱ GI reconstruction were more likely associated with gastric stump cancer, accounting for 69.8% of the total cases, and cancer was more likely to occur at the anastomotic stoma and in its vicinity, accounting for 62.3%. The 1'- , 3'- , and 5-year survival rates of 126 patients were 90.4%, 57.9%, and 41.2%, respectively. The 1'-, 3'- and 5-year overall survival rates in radical operation group were 96.9%, 74.2% and 53.6% respectively, while it was 69.0%, 3.4% and 0 respectively in palliative operation group (all P<0.01). Univariate analysis showed that tumor size, invasion depth, lymph node metastasis, distant organ metastasis, TNM stage, histological type, treatment mode and chemotherapy were related to the prognosis (all P<0.01). By multivariate analysis, radical resection and chemotherapy were protective factors for the prognosis ( P<0.01). Conclusion:Most gastric stump cancer are associated with distal subtotal gastrectomy and B-Ⅱ reconstruction . Radical resection is an effective therapy for gastric stump cancer.

Background: This study aimed to explore relationships between job stress and psychological adaptation and how they related to interpersonal needs through mood states among female migrant manufacturing workers. Methods: A cross-sectional survey was conducted in 16 factories in Shenzhen, China. Sociodemographic, job stress, psychological adaptation and other psychological information of was collected. Structural equation modeling was performed to delineate the internal relationship between variables. Results: The hypothetical structural equation model exhibited acceptable model fit among female migrant manufacturing workers (χ2 = 11.635, df = 2, χ2/df = 5.82, p = 0.003, RMSEA = 0.090, CFI = 0.972, SRMR = 0.020). Job stress was directly associated with mood states and interpersonal needs; Psychological adaptation was directly associated with mood states and indirectly associated with interpersonal needs; Bootstrapping tests demonstrated mediation effect of mood states in the way from psychological adaptation to interpersonal needs. Conclusion Female migrant manufacturing workers who suffered stress from job and the process of psychological adaptation may have worse mood states and workers with worse mood states are more likely to develop unmet interpersonal needs, a proximal factor of suicidal ideation.

Objective To investigate the evaluation and suggestion of the courses of Chinese Medicine for clinical students majoring in medical college. Methods In January 2017, at the end of the Chinese Medicine courses, a total of 35 clinical students of Capital Medical University were investigated through a questionnaire, mainly related to students' understanding of Chinese medicine; evaluation and suggestions for Chinese Medicine education and teaching. Results The majority of students believed that Chinese medicine was safe and effective. The proportion of believing worthing learning that the Chinese medicine accounted for 94.3% (33/35), and who believed Chinese medicine helpful for the clinical work accounted for 82.9% (29/35). However, the proportion of satisfaction with the current teaching method was 60% (21/35). Conclusions Most of the clinical students in this investigation have recognized the role of Chinese medicine, and have shown great interest in studying the course, but they are not satisfied with the current teaching. To improve the teaching quality of Chinese Medicine through the reform should be the direction of teachers' efforts in the future.

Objective To investigate the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in the pathogenesis of psoriasis by detecting the level of PCSK9 in the plasma of patients with psoriasis and evaluating its effect on the secretion of interferon gamma (IFN-γ) and interleukin-17A (IL-17A) by peripheral CD4+ T cells.Methods Totally,30 outpatients with psoriasis vulgaris and 30 healthy volunteers (controls) were enrolled from Hospital for Skin Diseases,Chinese Academy of Medical Sciences between February 2016 and December 2017.Of the 30 patients,16 were males,and 14 were females.Their age varied from 18 to 66 years,and the course of disease ranged from 1 month to 15 years.Peripheral venous blood samples were obtained from the patients and controls,and the plasma and was performed to measure mRNA expression of PCSK9 in the PBMC,and enzyme-linked immunosorbent assay (ELISA) to determine the concentration of PCSK9 in the plasma.Peripheral CD4+ T cells were isolated from the PBMC by magnetic bead method,and divided into 2 groups to be co-cultured with (experiment group) or without PCSK9 protein (control group).After 24-hour treatment,ELISA was conducted to detect the levels of IFN-γ and IL-17A in the culture supernatant.Statistical analysis was carried out by using two-sample t test for the comparison between the two groups,and Pearson correlation analysis for analyzing correlations between the plasma level of PCSK9 and psoriasis area and severity index (PASI) score in the patients with psoriasis.Results PCSK9 mRNA expression was undetected in the PBMC of the patients with psoriasis and controls.The plasma level of PCSK9 was significantly higher in the patients with psoriasis ([243.58 ± 11.91] μg/L) than in the healthy controls ([199.74 ± 31.09] μg/L,t =5.761,P ＜ 0.001).After co-culture of the peripheral CD4+ T cells from patients with PCSK9 protein,the levels of IFN-γ and IL-17A both significantly increased ([6 150.00 ± 212.13] ng/L,[1 532.00 ± 11.31] ng/L,respectively) compared with the control group co-cultured without PCSK9 protein ([4 650.00 ± 212.13] ng/L,[698.5 ± 266.58] ng/L,respectively;t =7.071,4.418 respectively,both P ＜ 0.05).IFN-γand IL-17A were undetected in the culture supernatant of CD4+ T cells from the healthy controls in the experiment group or control group.Conclusion The plasma level of PCSK9 increases in patients with psoriasis,which may be involved in the pathogenesis of psoriasis by activating peripheral CD4+ T cells.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*