Objective To study signs of ultrasonography in multiple renal arteritis (MRA) by color Doppler flow imaging(CDFI) and X-ray angiography.Methods 2-D ultrasonography and color Doppler were performed on 23 cases of MRA with 39 diseased blood vessels.The morphology and diameters of stenonsed renal arteries of the kidneys were observed respectively by 2-D ultrasonography and CDFI.CDFI was adopted to observe maximum of velocity(Vmax),minimum of velocity(Vmin),resistance index(RI),acclerate(ACC) and acclerated time(TA) of the renal arteries,and the values were compared with those by X-ray angiography and with those of the normal controls.Results MRA's renal volume and diameter were significantly different from those of controls ( P

Objective To explore the clinical value of detecting serum cystatinC (CysC) combined with β2‐microglobulin(β2‐MG) in assessing early kidney damage for patients with hypertensive disorder complicating pregnancy (HDCP) .Methods Totally 108 patients with HDCP were selected ,including 41 cases of gestational hypertension ,30 cases of mild preeclampsia ,37 cases of se‐vere preeclampsia ,moreover ,40 normal pregnant women were selected as control .The levels of serum CysC ,serum β2‐MG and ser‐um creatinine(Cr) were tested with automatic biochemistry analysator .Results The levels of serum CysC and β2‐MG in gestational hypertension group ,mild preeclampsia group and severe preeclampsia group were significantly higher than the control group (P<0 .05) .There were significantly differences among gestational hypertension group ,mild preeclampsia group and severe preeclampsia group of levels of CysC and β2‐MG (gestational hypertension group < mild preeclampsia group < severe preeclampsia group ,P<0 .05) .The level of Cr of severe‐preeclampsia group was significantly higher than the control (P< 0 .05) ,but it had no significant difference among gestational hypertension group ,mild preeclampsia group and control group (P> 0 .05) .In addition ,the results of correlation analysis showed there was a positive correlation among Cys‐C ,β2‐MG and Cr in the patients with HDCP .Conclusion There will be an important clinical value to evaluate the progression of the disease and diagnose early kidney damage through joint detectation of serum Cys‐C ,β2‐MG and and Cr .

BACKGROUND:Individuals with different vertical facial types have different chin morphologies. For the individuals with different vertical facial types, what is the most beautiful chin morphology?
OBJECTIVE:To evaluate the effects of vertical facial types and chin morphology on facial profile attractiveness.
METHODS:Three beautiful females were selected, including one with high mandibular angle, one with average angle and one with low angle. Their facial profile photographs were taken. A series of new pictures were generated by the smal scale (2 mm per unit) modification of soft tissue chin in the sagittal direction and vertical direction. Raters consisting of 17 orthodontists and 35 laypersons were selected for aesthetic ratings, in order to evaluate the facial profile attractiveness of the individuals with different vertical facial types.
RESULTS AND CONCLUSION:There was no esthetic difference of vertical change in female with high angle;while slightly protrude chin was perceived to be more beautiful than retruded chin. For the female with average angle, lower chin was more attractive than higher chin;slightly protruded chin was beautiful than excessive protruded chin and retruded chin. For the individual with low angle, higher chin was preferred by raters;slightly protruded chin was more beautiful than excessive protruded chin and retruded chin.The results indicate that the effects of vertical facial types and chin morphology to facial profile attractiveness are different. In clinical orthodontic, vertical facial types should be taking into consideration to change the chin morphology of the patents, in order to obtain better profile attractiveness.

Objective To evaluate the clinical value and toxicities of docetaxel plus capecitabine in the first-line treatment of metastatic breast cancer (MBC),and compare the outcomes among different molecular subtypes.Methods A total of 108 patients with MBC who received docetaxel plus capecitabine combination treatment between January 1,2012 and December 31,2015 in Bejing Chaoyang District Sanhuan Cancer Hospital were retrospectively analyzed,and 104 cases were available for evaluation.The clinicopathological characteristics,clinical value and toxicities of these patients were evaluated.Results The patients were divided into 3 molecular subtypes,among 104 patients,85 patients in Luminal subtype,14 patients in triple negative breast cancer (TNBC) subtype,and 5 patients in human epidermal growth factor receptor-2 (HER-2) over expression subtype.The treatment achieved objective responses (OR) in 55 patients (52.9％),and the disease control rate (DCR) was 88.5％,including complete response (CR) in 4 patients,partial response (PR) in 51 patients,stable disease (SD) in 37 patients,and progressive disease (PD) in 12 patients.In Luminal subtype,4 patients achieved CR,43 PR,33 SD,and 5 PD.In TNBC subtype,6 patients achieved PR,3 SD,5 PD.In the HER-2 over expression subtype,2 patients achieved PR,1 SD,2 PD.There was no significant difference in the short-term therapeutic effect among 3 molecular subtypes (x2 =4.429,P =0.106).As a result,the progression-free survival (PFS) of the 104 patients was 1.5-121.0 months,and the median PFS was 10.0 months.The median PFS was 11.0 months in Luminal subtype,4.0 months in TNBC subtype and 10.3 months in HER-2 over expression subtype,with a significant difference (x2 =7.510,P =0.006).The most common adverse events were hand-foot syndrome (HFS),nausea or vomiting,neutropenia,anaemia,diarrhea and so on.The incidence of grade 2/3 HFS was 44.2％ (46/104),and the grade 3/4 neutropenia was 39.4％ (41/104).Conclusion The first-line treatment of MBC using docetaxel plus capecitabine is effective,and the toxicities can be tolerable,especially in the Luminal subtype.

Objective To explore the effect of 5M1E quality analysis tool-based hand hygiene(HH) comprehensive intervention measures on pediatric healthcare-associated infection(HAI).Methods HH status of 29 health care workers(HCWs) in the pediatric department of a hospital was monitored, April-June 2015 was baseline survey stage, 5M1E quality analysis tool was adopted to analyze various factors affecting the compliance rate of pediatric HH, intervention measures began to be taken in June 2015, and compared with HH in July 2015-March 2016.The occurrence of HAI between July 2014-March 2015 and July 2015-March 2016 was compared.Results HH compliance rate of HCWs increased from 30.86% in April-June 2015 to 81.94% in January-March 2016;HH correct rate increased from 68.14% to 93.75%;HH compliance rate and correct rate of HCWs gradually increased(X2=2 608.626, 630.798,respectively, both P<0.001).Qualified rate of detection of HCWs' HH sampling increased from 20.69% in April-June 2015 to 89.66% in January-March 2016(X2=31.957,P<0.001).Incidence of HAI decreased from 7.74% in July 2014-March 2015 to 3.62% in July 2015-March 2016(X2=46.717,P<0.001).Conclusion Application of 5M1E quality analysis tool in the investigation, analysis, and comprehensive intervention in HCWs' HH in pediatric department has greatly enhanced HCWs' HH compliance rate, and reduced the incidence of HAI in pediatric patients.

Objective:To examine the clinical effectiveness of modified vaginal hysterectomy for the treatment elderly women with uterine prolapse.Methods:Eighty-two elderly patients with uterine prolapse treated in the Affiliated Hospital of Jiangnan University from January 2017 to August 2020 were selected as research subjects, who were randomly and double-blindly divided into the control group and the observation group, with 41 patients in each group.The control group was treated with traditional vaginal hysterectomy, while the observation group was treated with modified vaginal hysterectomy.Surgical parameters(operating time, intraoperative blood loss and length of hospital stay), total clinical effectiveness rates and the incidences of complications in the two groups were compared.Results:The total effectiveness rate of the observation group was higher than that of the control group(97.6% vs.78.0%, χ2=7.291; P<0.05). The operation time[(71.3±15.5)min vs.(122.7±22.2)min, t=7.379, P=0.008], intraoperative blood loss[(122.5±15.3)ml vs.(297.7±20.7)ml, t=9.820, P=0.000]and hospitalization time[(7.2±1.5)d vs.(10.0±2.9)d, t=7.164, P=0.014]of the observation group were lower than those of the control group.The incidence of complications in the observation group was lower than that in the control group(0.0% vs.14.6%, χ2=7.159, P<0.05). Conclusions:Modified vaginal hysterectomy for elderly patients with uterine prolapse can help improve the clinical effectiveness and reduce the operating time, postoperative length of hospital stay and the incidence of postoperative complications.

Objective:To observe the clinical effects of modified Maxing Shigan Decoction combined with acupoint application of Traditional Chinese Medicine (TCM) on inflammatory indicators and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with syndrome of phlegm-heat accumulated in the lung.Methods:Prospective cohort study. Eighty AECOPD patients with syndrome of phlegm-heat accumulated in the lung, who met the inclusion criteria in our hospital from October 2020 to January 2022 were included, and randomized into two groups by random number table methods, 40 in each group. The control group received conventional therapy of Western medicine, while the treatment group received modified Maxing Shigan Decoction combined with acupoint application of TCM on the basic treatment of control group. Both groups were treated for a course of 14 days. The white blood count (WBC) and percentage of neutrophil (NE%) were detected by automatic blood cell analyzer. Levels of C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay (ELISA). Pulmonary function parameters including forced expiratory volume in one second (FEV1), percentage of forced expiratory volume in one second (FEV1%), forced vital capacity (FVC) and FEV1/FVC were detected by spirometry. Meantime, the adverse reactions and clinical responsive rate were recorded in both groups.Results:The overall responsive rate was 90.0% (36/40) in treatment group, which had statistically significant difference with 70.0% (28/40) in control group (χ 2=5.00, P=0.025). After treatment, plasma WBC [(4.15±1.02)×10 9/L vs. (7.53±1.27)×10 9/L, t=13.12], NE% [(0.50±0.12)% vs. (0.65±0.13)%, t=5.36] and serum CRP [(8.12±5.58)mg/L vs. (25.15±8.50)mg/L, t=10.59] in the treatment group were significantly lower than those in the control group ( P<0.05). The FEV1 [(1.94±0.23)L vs. (1.71±0.35)L, t=3.47], FEV1% [(88.25±9.21)% vs. (74.10±8.13)%, t=7.29], FVC [(3.85±0.31)L vs. (3.12±0.23)L, t=12.29] and FEV1/FVC [(86.12±7.18)% vs. (75.30±8.32)%, t=6.23] in the treatment group were significantly higher than those in the control group ( P<0.05). The adverse reaction rate during treatment period yielded no significant difference between two groups ( P>0.05). Conclusion:Application of modified Maxing Shigan Decoction combined with acupoint application of TCM in the treatment of AECOPD with syndrome of phlegm-heat accumulated in the lung can effectively attenuate inflammation response and ameliorate the pulmonary function.

Objective:To evaluate the clinical efficacy of Jiawei Zhixiao Decoction and western medicine comprehensive therapy in acute attack of bronchial asthma of heat asthma syndrome.Methods:Randomized controlled trial. A total of 80 patients with acute exacerbation of bronchial asthma and TCM pattern heat asthma, who treated in the respiratory department of our hospital from January 2021 to December 2021, were selected. Accordlty to random number table method the patients were divided into the treatment group and control group, with 40 in each group. The patients in the control group were given comprehensive treatment of Western Medicine (bronchodilator and glucocorticoid, etc.). On the basis of comprehensive treatment of Western medicine, the treatment group was combined with Jiawei Zhixiao Decoction. All patients received a 14-day treatment. Before and after treatment, the TCM symptom scores were recorded, FEV1 and forced expiratory volume in one second to forced vital capacity ratio (FEV1/FVC) were measured by pulmonary function meter, and peak expiratory flow (PEF) was measured by peak expiratory flow meter. Serum TNF-α and IL-8 levels were detected by ELISA, and procalcitonin (PCT) was detected by electrochemiluminescence. The disease grade, clinical efficacy and adverse reactions were also recorded.Results:The total effective rate was 95.0% (38/40) in the treatment group and 80.0% (32/40) in the control group, the difference between the two groups was statistically significant ( χ2=4.11, P=0.043). After treatment, the TCM symptom score of the treatment group was significantly lower than that of the control group ( t=7.91, P<0.01). FEV1 [(2.83±0.37) L vs. (2.38±0.32) L, t=6.77], FEV1/FVC [(85.37±9.36) % vs. (75.50±10.24) %, t=4.50], PEF [(4.84±0.82) L vs. (3.92±0.43) L, t=6.28] was significantly higher than that of control group ( P<0.01). Serum IL-8 [(80.59±10.28) ng/L vs. (87.15±8.25) ng/L, t=3.15], TNF-α [(43.18±4.08) ng/L vs. (51.78±7.58) ng/L, t=6.32], PCT [(0.84±0.35) μg/L vs. (0.41±0.12) μg/L, t=7.35] were significantly lower than those in control group ( P<0.01). The improvement of asthma grade was significantly better than that of control group ( Z=17.86, P<0.05). During the observation period, there were no serious adverse reactions in both groups, and the safety was high. Conclusion:Application of Jiawei Zhixiao Decoction and western medicine comprehensive therapy in acute attack of bronchial asthma of heat asthma syndrome can effectively improve the TCM symptoms and lung function, attenuate the inflammation response, and alleviate the severity of asthma.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

OBJECTIVE：To understand the situation of healthcar e workers’occupational exposure of hazardous drugs （chemotherapeutic drugs and antiviral drug ）and relative cognition level ，and to provide reference for improving the level of occupational protection. METHODS ：During Oct. 2018 to Mar. 2019，healthcare workers from 12 hospitals of different levels and different departments in Shaanxi province were selected as respondents to conduct a self-designed questionnaire survey. Information we surveyed contained baseline characteristics ，hazardous drugs exposure ，physical health status ，and occupational protection. Valid questionnaires were collected and analyzed statistically. RESULTS ：A totally of 1 848 questionnaires were sent out ，and 1 767 questionnaires were collected ，including 95 were pharmacists ，100 were physicians ，and 1 572 were nurses. The frequency of diarrhea and menstrual disorders in healthcare workers with long-term exposure to antiviral drugs （antiviral drug exposure group ） and cross-exposure to antiviral drugs and chemotherapeutic drugs （cross-exposure group ）were significantly higher than unexposed group （P＜0.05）. The incidence of routine blood abnormalities in cross-exposure group ，antiviral drug exposure group and healthcare workers with long-term exposure to chemotherapy drugs （chemotherapy drug exposure group ） was higher than unexposed group by 9.13％，5.50％ and 12.34％，respectively. 84.7％ of the respondents had little knowledge of hazardous drugs ， and 8.15％ of the respondents had never received occupational protection training. Additionally ，the ratio of healthcare workers receiving occupational protection training in the cross-exposure group was significantly higher than unexposed group （P＜0.05）， and the ratio of healthcare workers receiving occupational protection training in antiviral drug exposure group were significantly lower than unexposed group （P＜0.05）. CONCLUSIONS ：Long-term exposure to hazardous drugs will cause certain occupational hazards to healthcare workers. It is necessary to improve healthcare workers ’awareness of self-protection ，increase the input of hospitals in occupational protection training and establish occupational protection standards in order to improve the current situation of occupational protection of healthcare workers.