Objective:To analyze the current hotspots of international research on patient safety in recent 10 years, and to provide reference for the scientific research and practical management of patient safety in China.Methods:Based on Web of Science database, CiteSpace visual analysis software was used to analyze the related literature on patient safety collected from January 2009 to December 2018. Word frequency analysis and Co-word clustering were performed on research institutions, authors, countries, journals, cited literature and high frequency keywords.Results:At present, the international research on patient safety is mainly concentrated in European and American higher educational institution with Harvard University as the core; the core journals are The Journal of the American Medical Association, New England Journal of Medicine, Lancet and other journals with the highest international academic influence; the patient safety phase is excavated through keyword co-occurrence cluster analysis. There are 9 international research hotspots, such as safety practice management, safety index research, safety education and safety culture construction. Conclusion:The relevant research background and current situation in the international field of patient safety are in a mature and stable stage. The research team is mainly concentrated in developed areas such as Europe and the United States, and a more closely cooperative and shared research model has been formed. The research hotspot and focus are closely around the multi-disciplinary and multi-field research theme of "patient-centered" advocated by the World Health Organization, which is worthy of domestic researchers' reference and learning. Also, the research and exploration work cored on patient safety domestically needed to be further structured and promoted.

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.

With the development of social economy and the full opening of the three-child policy, more and more elderly people will become the main force in raising grandchildren in the future, and the mental health of the elderly in intergenerational raising has become the focus of the whole society. This article summarizes the causes of the intergenerational raising, the mental health status of the elderly in intergenerational raising, and reviews the influencing factors of the mental health of the elderly in intergenerational raising, in order to provide a reference for the construction of the social security system for the elderly and young people in China.

Objective To analyze the clinicopathological features and prognostic factors of patients with breast invasive ductal carcinoma with extensive intraductal components (EIC).Methods The clinical data of 182 patients of early breast invasive ductal carcinoma undergoing breast-conserving surgery were analyzed retrospectively in the Second Affiliated Hospital of Soochow University,and the clinicopathological features and prognosis of two groups of breast cancer patients with EIC positive (n =23) and EIC negative (n =159) were compared.Results In the EIC positive group,ipsilateral breast tumor recurrence (IBTR) was 21.7％ (5/23) and the distant metastasis rate was 4.3％ (1/23);in the EIC negative group,ipsilateral breast tumor recurrence (IBTR) was 1.9％ (3/159) and the distant metastasis rate was 3.8％ (6/159).The Kaplan-Meier curve showed that the 5-year local recurrence-free survival rates in the EIC positive group was lower than that of the EIC negative group (78％ vs.97.7％) (P ＜ 0.001),and the difference was statistically significant,but the 5-year distant metastasis-free survival rates in the two groups was similar (95.7％ vs.96.2％) (P =0.892).COX multivariate analysis showed that EIC was an independent risk factor for local recurrence after breast-conserving surgery in breast invasive ductal carcinoma patients.Conclusions EIC increases the local recurrence rate in patients with breast invasive ductal carcinoma undergoing breast-conserving surgery.

Objective:To compare the efficacies of MRI, X-ray mammography (XMG) and Ultrasound (US) in detecting and diagnosing breast ductal carcinoma in situ (DCIS).Methods:Two hundred and forty one consecutive patients with pathology-confirmed DCIS were retrospectively recruited from January 2011 to December 2017 in PLA General Hospital. The imaging examination modalities included MRI and/or XMG and/or US.The breast imaging reporting and data system (BI-RADS) categorizations by MRI, XMG and US were compared and their sensitivities of detecting DCIS were calculated. The causes of underestimation on MRI were interpreted with the information of XMG and US. Chi-square test was used to compare the differences.Results:The diagnostic sensitivity of XMG, US and MRI was 65.9% (29/44), 71.6% (101/141) and 91.2% (145/159), respectively, with statistical significant differences (χ2 =24.034, P<0.001). Breast density and lesion type would influence the sensitivity of XMG. And the sensitivity of US was decreased because of non-mass lesion. Of the 14 cases under-evaluated as BI-RADS category 1 to 3 on MRI, 5 were corrected by XMG and/or US to BI-RADS category 4. The cause of underestimation on MRI was the coexistence of DCIS with adenoma or other benign lesion. Conclusion:The retrospective comparison of MRI, XMG and US in this study showed that MRI had significant higher sensitivity in detecting breast DCIS, while the false negative rates of XMG and US were un-negligible.

BACKGROUND:As the incidence of spinal cord injury increases with the years and axon regeneration after spinal cord injury was very difficult.How to promote the recovery from spinal cord injury and improve the transplantation efficiency of stem cells and other therapeutic cells after spinal cord injury has been the focus of clinical and scientific research. OBJECTIVE:To establish the efficient transplantation and replacement of mouse spinal cord microglia in the spinal cord injury model. METHODS:CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice,CX3CR1+/GFP mice,β-actin GFP mice and C57 BL/6J wild-type mice at 8-10 weeks of age were selected.According to the requirements of the experiment,they were randomly divided into six groups.(1)Sham operation group:eight C57 BL/6J wild-type mice were used when only the lamina was removed without injury.(2)Spinal cord contusion injury group:eight C57 BL/6J wild-type mice were used.(3)Spinal cord crush injury group:eight C57 BL/6J wild-type mice were used.(4)Conjoined symbiotic spinal cord strike injury group:β-actin GFP mice with green fluorescent blood were surgically stitched together with C57 BL/6J wild-type mice,using eight β-actin GFP mice and eight C57 BL/6J wild-type mice.(5)Mr BMT-X Ray group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with X-ray radiation):Bone marrow cells from four CX3CR1 creER-/+::LSL-BDNF-/+-tdTomato mice were extracted and transplanted into eight C57 BL/6J wild-type mice for spinal cord injury modeling.(6)Mr BMT-Busulfan group(using PLX5622 to eliminate the spinal microglia and bone marrow transplantation with Busulfan):Bone marrow cells from four CX3CR1+/GFP mice were transplanted into eight C57 BL/6J wild-type mice.The percentage of cell transplantation replacement in this group was observed,and the spinal cord injury model was not established in this group.The sham operation group,spinal cord contusion injury group and spinal cord crush injury group were sampled by perfusion on day 14 after spinal cord injury.The conjoined symbiotic spinal cord strike injury group was sampled by perfusion on day 7 after spinal cord injury.Mr BMT-X Ray group was sampled by perfusion on day 28 after spinal cord injury.Mr BMT-Busulfan group was sampled by perfusion on day 28 after transplantation.The sampling site was a 1.2 cm long spinal cord with the T10 segment as the center.In the Mr BMT-X Ray group and Mr BMT-Busulfan group,additional mouse brain tissue was retained to see if it would lead to brain transplantation and replacement.The number and proportion of transplanted and replaced cells in the damaged area were measured using transgenic mice,symbiosis and immunofluorescence. RESULTS AND CONCLUSION:Compared with the traditional peripheral blood transplantation(9.8%)of mice in the conjoined symbiotic spinal cord strike injury group,the new transplantation methods,Mr BMT-X Ray and Mr BMT-Busulfan,could greatly improve the proportion of spinal microglia transplantation and replacement,which could reach 84.8%and 95.6%,respectively.The difference was significant(P<0.05).The results showed that Mr BMT-X Ray and Mr BMT-Busulfan could achieve efficient replacement of spinal microglia cells,and could improve the problems of low cell transplantation efficiency,few survival numbers and unclear differentiation of the traditional cell transplantation methods.In addition,Mr BMT-X Ray can only replace the microglia in the spinal cord,while Mr BMT-Busulfan could avoid brain inflammation and injury caused by X-ray radiation transplantation.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.

Objective:To explore the clinical application value of magnetic stimulation combined with biofeed-back technology in female stress urinary incontinence(SUI).Methods:Sixty mild or moderate female SUI patients who underwent rehabilitation treatment at the Pelvic Floor Rehabilitation Center of Nanjing Women and Children's Healthcare Hospital from July to December 2021 were collected and randomly divided into two groups,with 30 pa-tients in each group.The observation group received a treatment protocol of electrical stimulation+biofeedback therapy(electric combined group)and the other group received a treatment protocol of magnetic stimulation+bi-ofeedback therapy(magnetic combined group).The treatment course for both groups consisted of 12 sessions.The Sandvik severity Index(urinary incontinence),the amount of u 1-hoururine leakage,pelvic floor muscle strength,pelvic floor muscle electrophysiological indices,the degree of urinary incontinence impact(ⅡQ-7 score)and the treatment efficacy were assessed and compared before and after the treatment in the two groups.Re-sults:Compared with the pre-treatment,the Sandvik Severity Index,the 1-hour urine leakage,and the n Q-7 score decreased in the magnetic combined group and the electric combined group after treatment,while the mus-cle strength of type Ⅰ,type Ⅱ,maximum of fast muscle,and mean value of slow muscle increased significantly,and the differences were statistically significant(P＜0.05).The difference between the above indexes was not statistically significant when comparing the magnetic combined group and the electric combined group after treat-ment(P＞0.05),and the treatment efficiency of the electric combined group was 93.33％and that of the magnet-ic combined group was 96.67％,and there was no statistical significance when comparing the efficiency of the two groups(P＞0.05).Conclusions:Magnetic stimulation combined with biofeedback technology has high thera-peutic efficiency for mild or moderate SUl,and is an optional rehabilitation technique for women with SUI.