is able to provide pathologic data and achieve the efficacy equivalent to surgery.

Objective To evaluate the double-balloon enteroscopy(DBE) for obscure gastrointestinal bleeding(OGIB) and evaluate the health economics under the guidance of DBE for surgical treatment of obscure gastrointestinal bleeding.Methods A total of 114 patients,whose hemorrhage etiology could not be determined by conventional gastroscopy,enteroscopy and gastroenterography,underwent DBE.With pathological results as diagnostic criteria,the value of double-balloon enteroscopy for obscure gastrointestinal bleeding diagnosis was studied.Results The sensitivity,specificity and accuracy of DBE for OGIB were 85.86％,63.63％,81.57％,respectively.The positive likelihood ratio was 2.36 and the negative likelihood ratio was 0.22.The total days of hospitalization,hospital costs,cost of hospital drugs were lower in the DBE group than in the control group(27.2 ± 11.8 days VS 16.4 ±5.3 days,35 690.2 ±3 466.5 Yuan VS 19 409.3 ± 9 253.2 Yuan,17 805.8 ± 2 145.5 Yuan VS 9 133.0 ± 4 664.9 Yuan) (all P ＜ 0.05).Conclusion DBE plays an important role in diagnosis of OGIB.It has significance in clinic,health economics,and social benefits.

Objective To explore factors related to the development of segmental instabilities in lumbar spine. Methods Fifty-seven patients with lumbar segment instabilities at L 4～5 were selected as illness group, 22 patients with facetectomy at L 4～5 as post-operation control group, and 19 healthy subjects as normal control. X-ray plain films were taken in sagittal,flexion and extension positions. Computed tomographic scans were taken to define the axial morphology of the facet joint. Magnetic resonance scans were taken to describe disc degeneration of 36 patients in illness group. Results The facet joint was oriented sagittally in the forward translation patients in flexion. The disc degeneration was slight in the rotational instability patients. The patients with total facetectomy exited forward translation in flexion. Conclusion A more sagittally oriented facet and disc degeneration are associated with forward translation in flexion and may be the cause of degenerative spondylolisthesis, whereas ligament failure is associated with rotational instability.

Apoptosis ; drug effects ; Cell Line, Tumor ; Drug Synergism ; Flavanones ; administration & dosage ; pharmacology ; Humans ; Multiple Myeloma ; pathology ; Thalidomide ; administration & dosage ; analogs & derivatives ; pharmacology

Objective To evaluate the application of cough reflex testing with various concentrations of citric acid for dysphagia post stroke. Methods 20 normal controls (NC), 20 stroke patients with dysphagia (SD) and 20 stroke patients without dysphagia (SND) were tested with cough reflex inhalated 4 kinds of dosage of citric acid: 0.2 mol/L, 0.4 mol/L, 0.6 mol/L and 0.8 mol/L. Results The incidence of pass (coughed twice or more) decreased in the SD compared with those in the NC as inhalated citric acid of 0.2 mol/L and 0.4 mol/L (P< 0.05), and decreased under 0.4 mol/L compared with the SND (P<0.05). There was no significant difference between the SND and the NC (P>0.05). 90% of the NC passed as inhalated citric acid of 0.4 mol/L; however, it was 45% in the SD, and increased when they inhalated more dosage of citric acid (P<0.05). The incidence of pass decreased under 0.2 mol/L citric acid in the SND compared with other concentration (P<0.05). The result of the test was reliable interrater (κ=0.97). The incidence of cough was consistent of 96.8% with the same concentration. No asthma and asphyxia was observed. Conclusion Cough reflex testing with citric acid inhalation can be used to assess the defensive function of airway in lower concentration for dysphagia after stroke.

Objective:To explore clinical application value of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer.Methods:The clinical data of 30 breast cancer patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy from January 2016 to January 2018 were collected. In the observation group, 15 patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy. In the control group, 15 patients underwent conventional modified radical mastectomy only. The differences of operation indicator and postoperative complications between the two groups were compared, and the postoperative cosmetic effects were evaluated.Results:The patients successfully completed prosthetic breast reconstruction in the observation group. The surgical time and indwelling time of the drainage tube in the observation group were both increased compared with the control group, and the difference was statistically significant ( t=118.8 and t=23.9, P<0.05). There were no statistically significant differences between the two groups in the complications of postoperative flap necrosis, subcutaneous hematoma, intraoperative infection and incision dehiscence ( P>0.05). The total complications rate of the observation group was 40%, compared with the control group (20%), there were not statistically significant differences ( P>0.05). The postoperative aesthetic effect evaluation showed that the reconstructed breast was full in shape and basically symmetrical to the contralateral side, with an excellent and good rate of 83.3%. The patients were satisfied with the appearance of the breast. All patients were followed up for 12 to 36 months with the average time of 24 months, and local recurrence and distant metastasis were not observed. Conclusions:In the modified radical mastectomy for breast cancer with preserved nipple and areola, the immediate application of silicone prosthesis for breast reconstruction has the advantages of less trauma, faster postoperative recovery and better cosmetic effect, which is worthy of clinical application.

OBJECTIVETo establish a RRLC-UV method for simultaneous determination of nine phenolic acids in Salvia miltiorrhiza.

METHOD3,4-Dihydroxyphenylacetic acid was used as internal standard, and analysis was carried out on an Agilent Zorbax Eclipse Plus C18 (2.1 mm x 50 mm, 1.8 microm) column with acetonitrile-0.1% formic acid aqueous solution as mobile phases in gradient elution. The flow rate was 0.3 mL x min(-1), and the UV detector was monitored at 286 nm.

RESULTAll calibration curves showed good linear regression within test ranges (r > or = 0.999 5); and the overall recoveries were in the range of 98.2%-102.6%, with RSD less than 3.1% (n = 3). The overall RSD of precision test were less than 2.4%.

CONCLUSIONThe developed method was simple, rapid, accurate and reproducible, and can be used for the quality control of S. miltiorrhiza.

Chromatography, High Pressure Liquid ; instrumentation ; methods ; Drugs, Chinese Herbal ; analysis ; Hydroxybenzoates ; analysis ; Salvia miltiorrhiza ; chemistry ; Spectrophotometry, Ultraviolet

OBJECTIVETo observe the influences of Panax notoginsenosid(a compound of Chinese Traditional Medicine) on the spontaneous contraction of small intestine smooth muscle of rabbits in vitro and explore the mechanism.

METHODSThe influences of Panax notoginsenosid on the spontaneous contraction of small intestine in intacted rabbits(male or female) after the isothermal perfuse of small intestine in vitro were observed. Bay K8644 and nitro-L-arginine methylester (L-NAME) were added to the normal Tyrode's solution respectively before Panax notoginsenosid. In the Ca2+ free Tyrode's solution, rynodine was added before Panax notoginsenosid. The mechanism of Panax notoginsenosid was studied.

RESULTSPanax notoginsenosid reduced the amplitude of contraction of small intestine smooth muscle in rabbits in a does-depended manner. Bay K8644 and L-NAME could completely block the inhibition of Panax notoginsenosid on the contraction of small intestine smooth muscle. Panax notoginsenosid inhibited significantly the intracellular calcium-depended contraction induced by rynodine in the Ca2+ free Tyrode's solution.

CONCLUSIONPanax notoginsenosid inhibits significantly the contraction of small intestine smooth muscle of rabbits in vitro. The mechanism may be related to increase NO concentration in small intestine smooth muscle so that inhibit extracellular Ca2+ inflowing via cell membrane and intracellular Ca2+ releasing via sarcoplasmic reticulum.

Animals ; Calcium ; metabolism ; Depression, Chemical ; Drugs, Chinese Herbal ; pharmacology ; Female ; In Vitro Techniques ; Intestine, Small ; physiology ; Male ; Muscle Contraction ; drug effects ; Muscle, Smooth ; metabolism ; physiology ; Nitric Oxide ; metabolism ; Panax notoginseng ; chemistry ; Rabbits

Objective: To explore the relationship between 24 hour movement behavior and physical fitness in college students, so as to provide a reference for physical fitness interventions for college students. Methods: A survey was conducted from September 23 to November 12, 2022, involving 342 college students selected from one comprehensive college among Shanghai City, Hubei Province and Zhejiang Province. Accelerometers were used to measure 24 hour movement behavior, and programs specified in the National Physical Fitness Standards for Students (2014 revision) were used to evaluate physical fitness. Compositional linear regression was used to analyze the association between 24 hour movement behavior and physical fitness. The effects of compositional isotemporal substitution of 24 hour movement behavior on physical fitness were also examined. Results: The geometric means for sleep, sedentary behavior, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were 515.89, 678.88 , 196.30, 48.92 min/d, respectively, and the comprehensive physical fitness score was (73.09±8.55). The proportion of participants who passed the fitness test was 72.51%. Overall, 20.76% had excellent or good scores, whereas 6.73% failed. Compositional linear regression indicated that physical fitness was significantly positively associated with MVPA ( β =2.55) and LPA ( β = 5.88 )( P <0.05), but no significantly associated with sleep ( β =-5.18) and sedentary behavior ( β =-3.24)( P >0.05). Isotemporal substitution indicated that reallocation of 15 minutes from sleep and sedentary behavior to MVPA resulted in a 0.71 and 0.64 point increase in physical fitness, respectively. Similarly, reallocating the same duration to LPA led to a 0.50 and 0.43 point increase in physical fitness, respectively. Dose response analysis revealed that the mutual substitution of LPA with sedentary behavior and sleep had symmetry, whereas the mutual substitution of MVPA with sedentary behavior and sleep had asymmetry. The effectiveness of replacing sleep or sedentary behavior with MVPA in improving physical fitness decreased with increasing allocation time, whereas the adverse effects of replacing MVPA with sleep or sedentary behavior increased with increasing allocation time. Conclusion In the context of 24 hour movement behavior, increasing the time spent on LPA and MVPA is beneficial for physical fitness among college students. It should be recommend that college students actively transition from sedentary behavior to engaging in physical activity, with a particular emphasis on incorporating MVPA.

Objective To analyze the prevalence,disease burden,and trends of diabetes in China from 1999 to 2019,providing reference for diabetes prevention and control as well as health resource allocation to alleviate the disease burden.Methods Data on the disease burden of diabetes in China from 1999 to 2019 were collected from the Global Burden of Disease(GBD)2019 database.Indicators such as incidence rate,prevalence rate,mortality rate,disability-adjusted life years(DALYs),years of life lost due to premature mortality(YLLs)and years lived with disability(YLDs)were used to analyze the diabetes burden in China by gender,age and year.The estimated annual percentage change(EAPC)was used to measure the temporal trend of standardized rates over a specified period,and the rank sum test was used to assess the gender differences in disease burden.Results In 2019,3.78×106 cases of diabetes and 1.73×105 deaths were reported in China.Compared with 1999,the standardized rates of incidence and prevalence increased by 5.80%and 17.12%,respectively,while the standardized mortality rate decreased by 2.82%.Compared with 1999,the standardized rates of DALYs and YLDs increased by 2.86%and 16.06%,respectively,while the standardized YLL rate decreased by 14.39%.The EAPC for diabetes incidence,prevalence,YLDs,and DALYs in the 20-40 age group all exceed 0,indicating an annually upward trend in disease burden of diabetes.Additionally,the disease burden in males was significantly higher than that in females(P＜0.05),and the gap is continuously widening.Conclusions The disease burden of diabetes in China is severe,particularly in term of life loss due to disability.The population with diabetes onset is becoming increasingly younger.Males constitute a high-risk population for diabetes-related morbidity and mortality.Diabetes prevention and control efforts should continue to enhance behavioral interventions,appropriately tilt health resource allocation towards high-risk population,and focus on improving the rehabilitation capabilities and promoting rehabilitation technology at grass-roots unit.